Active NPI
Leslie Anne Myer, OTR/L
- Occupational Therapist
- Fargo, ND
National Provider Identifier
1003222878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1352
- Practice address
- 3000 32ND Ave S
Fargo, ND 58103-6132 - Phone
- (701) 364-8000
- Fax
- (701) 364-8078
- NPI assigned
- Jul 1, 2014
- Last updated
- Dec 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1352 | ND | Primary |
Addresses
Primary practice location
3000 32ND Ave S
Fargo, ND 58103-6132
Mailing address
PO Box 6001
Fargo, ND 58108-6001
Phone (701) 364-8000
Other names 1
- Leslie Mitfin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1352 | ND | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovis Health, LLC | Current | Accepting new patients |
Locations
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222
3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-4222
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450828800000",
"number": "1003222878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6001",
"city": "FARGO",
"state": "ND",
"postal_code": "581086001",
"telephone_number": "701-364-8000",
"fax_number": "701-364-8078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 32ND AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581036132",
"telephone_number": "701-364-8000",
"fax_number": "701-364-8078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYER",
"first_name": "LESLIE",
"middle_name": "ANNE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-01",
"last_updated": "2015-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ND",
"license": "1352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LESLIE",
"last_name": "MITFIN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.