Individual provider Active NPI

Douglas Allen Osborne, OT/L

  • Occupational Therapist
  • Lexington, KY
National Provider Identifier
1104543552
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
135420 Issued in KY
Practice address
330 Waller Ave Ste 275
Lexington, KY 40504-2930
Phone
(859) 447-8600
Fax
(859) 447-8599
NPI assigned
Oct 26, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 135420 KY Primary

Addresses

Primary practice location

330 Waller Ave Ste 275
Lexington, KY 40504-2930

Mailing address

330 Waller Ave Ste 275
Lexington, KY 40504-2930
Phone (859) 447-8600

Other practice location 1

1013 Camellia Dr
Lexington, KY 40504-3221
Phone (185) 935-1013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250731002268 KY Practitioner - Occupational Therapist in Private Practice 3577071752 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135420KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Hand Therapy Occupational Therapist CurrentSince Jun 30, 2025 Accepting new patients
Commonwealth Hand Therapy Occupational Therapist CurrentSince Jun 30, 2025 Accepting new patients

Locations

127 Clay Dr
Berea, KY 40403
Phone (859) 756-3281

938 Louisville Rd
Ste 200
Frankfort, KY 40601
Phone (502) 300-6101

105 Lawson Dr
Ste 4
Georgetown, KY 40324
Phone (502) 642-5400

2443 Sir Barton Way
Ste 125
Lexington, KY 40509
Phone (859) 551-3381

330 Waller Ave
Ste 275
Lexington, KY 40504
Phone (859) 447-8599

100 Bacho Way
Ste 300
London, KY 40741
Phone (606) 657-0733

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1104543552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 WALLER AVE STE 275",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042930",
            "telephone_number": "859-447-8600",
            "fax_number": "859-447-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 WALLER AVE STE 275",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042930",
            "telephone_number": "859-447-8600",
            "fax_number": "859-447-8599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1013 Camellia Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405043221",
            "country_code": "US",
            "telephone_number": "185-935-1013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "DOUGLAS",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "OT/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-26",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "135420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.

Verify at the official NPI Registry.