Individual provider Active NPI

Leocharlson Jean-Louis, OTR/L

  • Hand Occupational Therapist
  • Jonesboro, GA
National Provider Identifier
1184049306
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT005869 Issued in GA
Practice address
335 Upper Riverdale Rd
Suite B-10
Jonesboro, GA 30236-1099
Phone
(770) 907-5743
NPI assigned
Feb 25, 2014
Last updated
Feb 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X OT005869 GA Primary

Addresses

Primary practice location

335 Upper Riverdale Rd
Suite B-10
Jonesboro, GA 30236-1099

Mailing address

335 Upper Riverdale Rd
Suite B-10
Jonesboro, GA 30236-1099
Phone (770) 907-5743

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250206003310 GA Practitioner - Occupational Therapist in Private Practice 2062942956 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc CurrentSince Oct 1, 2024 Accepting new patients
Physiotherapy Associates Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

335 Upper Riverdale Rd
Ste B10
Jonesboro, GA 30236
Phone (770) 907-4753

966A Killian Hill Rd SW
Lilburn, GA 30047
Phone (770) 923-4815

2155 Post Oak Tritt Rd
Ste 400
Marietta, GA 30062
Phone (770) 565-4044

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, 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": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1184049306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 UPPER RIVERDALE RD",
            "address_2": "SUITE B-10",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361099",
            "telephone_number": "770-907-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 UPPER RIVERDALE RD",
            "address_2": "SUITE B-10",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361099",
            "telephone_number": "770-907-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN-LOUIS",
        "first_name": "LEOCHARLSON",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "GA",
            "license": "OT005869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.