Active NPI
Martha Lea, OTR/L
- Occupational Therapist
- Minneapolis, MN
National Provider Identifier
1114390523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 104969
- Practice address
- 9220 Bass Lake Rd
#260
Minneapolis, MN 55428-3000 - Phone
- (763) 533-0363
- NPI assigned
- Nov 6, 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 | 104969 | MN | Primary |
Addresses
Primary practice location
9220 Bass Lake Rd
#260
Minneapolis, MN 55428-3000
Mailing address
9220 Bass Lake Rd
#260
Minneapolis, MN 55428-3000
Phone (763) 533-0363
Other names 1
- Martha Anderson
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104969 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547078400000",
"number": "1114390523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9220 BASS LAKE RD",
"address_2": "#260",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554283000",
"telephone_number": "763-533-0363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9220 BASS LAKE RD",
"address_2": "#260",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554283000",
"telephone_number": "763-533-0363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEA",
"first_name": "MARTHA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-06",
"last_updated": "2019-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "104969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARTHA",
"last_name": "ANDERSON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.