Individual provider Active NPI

Alexis Lee, OTR/L

  • Occupational Therapist
  • Copley, OH
National Provider Identifier
1144890583
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT010417 Issued in OH
Practice address
3777 Fairway Park Dr Apt 204
Copley, OH 44321-3119
Phone
(585) 490-2390
NPI assigned
Jun 28, 2021
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 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 OT010417 OH Primary

Addresses

Primary practice location

3777 Fairway Park Dr Apt 204
Copley, OH 44321-3119

Mailing address

3777 Fairway Park Dr Apt 204
Copley, OH 44321-3119
Phone (585) 490-2390

Other names 1

  • Alexis Kennedy Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210802001676 OH Practitioner - Occupational Therapist in Private Practice 9638573470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

355 W Central Ave
Springboro, OH 45066-1293
Phone (937) 345-0969

4515 22ND St NW
Canton, OH 44708-1573
Phone (330) 406-7504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT010417OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince May 5, 2025 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Jul 7, 2021 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Jul 7, 2021 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince May 5, 2025 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 5

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1144890583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3777 FAIRWAY PARK DR APT 204",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443213119",
            "telephone_number": "585-490-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3777 FAIRWAY PARK DR APT 204",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443213119",
            "telephone_number": "585-490-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ALEXIS",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT010417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "KENNEDY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Copley, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.