Active NPI
Leslie Jane Bodkin, MS, OTR/L, CEIS
- Occupational Therapist
- Somerville, MA
National Provider Identifier
1073796900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- AH6913-OT
- Practice address
- 61 Medford St
Somerville, MA 02143-3421 - Phone
- (617) 629-3919
- Fax
- (617) 629-4644
- NPI assigned
- Dec 13, 2007
- Last updated
- Dec 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | AH6913-OT | MA | Primary |
Addresses
Primary practice location
61 Medford St
Somerville, MA 02143-3421
Mailing address
61 Medford St
Somerville, MA 02143-3421
Phone (617) 629-3919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AH6913-OT | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197504000000",
"number": "1073796900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 MEDFORD ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021433421",
"telephone_number": "617-629-3919",
"fax_number": "617-629-4644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 MEDFORD ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021433421",
"telephone_number": "617-629-3919",
"fax_number": "617-629-4644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODKIN",
"first_name": "LESLIE",
"middle_name": "JANE",
"name_prefix": "Ms.",
"credential": "MS, OTR/L, CEIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-13",
"last_updated": "2007-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "AH6913-OT",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.