Individual provider Active NPI

Leah Shissias Planchard, MS, OTR/L

  • Pediatric Occupational Therapist
  • Roswell, GA
National Provider Identifier
1164675260
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT005374 Issued in GA
Practice address
1000 Holcomb Woods Pkwy Ste 422
Roswell, GA 30076-4718
Phone
(770) 641-8070
Fax
(770) 641-8078
NPI assigned
Nov 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT005374 GA Primary

Addresses

Primary practice location

1000 Holcomb Woods Pkwy Ste 422
Roswell, GA 30076-4718

Mailing address

10615 Tuxford Dr
Alpharetta, GA 30022-7068
Phone (609) 432-1090

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

LicenseStateTypeSpecialty
OT005374GAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Childrens Therapy Center Pediatrics CurrentSince Jun 25, 2023 Accepting new patients
Van Varick Pediatric Physical Therapy PastSince Jun 25, 2023 Accepting new patients

Locations

1000 Holcomb Woods Pkwy
Ste 422
Roswell, GA 30076
Phone (770) 641-8070

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": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1164675260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10615 TUXFORD DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300227068",
            "telephone_number": "609-432-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HOLCOMB WOODS PKWY STE 422",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764718",
            "telephone_number": "770-641-8070",
            "fax_number": "770-641-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLANCHARD",
        "first_name": "LEAH",
        "middle_name": "SHISSIAS",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-03",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT005374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.