Active NPI
Charles Richard Leidner, OTR
- Specialist
- Clearwater, FL
National Provider Identifier
1144558180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OT 4918
- Practice address
- 3141 N McMullen Booth Rd
Clearwater, FL 33761-2035 - Phone
- (727) 723-7735
- Fax
- (727) 726-7696
- NPI assigned
- Dec 3, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | OT 4918 | FL | Primary |
Addresses
Primary practice location
3141 N McMullen Booth Rd
Clearwater, FL 33761-2035
Mailing address
3141 N McMullen Booth Rd
Clearwater, FL 33761-2035
Phone (727) 723-7735
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OT 4918 | Other | FL | FLORIDA OT LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 4918 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259798400000",
"number": "1144558180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3141 N MCMULLEN BOOTH RD",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337612035",
"telephone_number": "727-723-7735",
"fax_number": "727-726-7696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3141 N MCMULLEN BOOTH RD",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337612035",
"telephone_number": "727-723-7735",
"fax_number": "727-726-7696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIDNER",
"first_name": "CHARLES",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-03",
"last_updated": "2009-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "OT 4918",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA OT LICENSE",
"identifier": "OT 4918",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.