Active NPI
Lesley Crider
- Occupational Therapist
- Paducah, KY
National Provider Identifier
1215078092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- KY-R3597
- Practice address
- 5150 Village Square Dr
Paducah, KY 42001-9060 - Phone
- (270) 443-0681
- NPI assigned
- Feb 12, 2007
- 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 | KY-R3597 | KY | Primary |
Addresses
Primary practice location
5150 Village Square Dr
Paducah, KY 42001-9060
Mailing address
940 Aspen Way
Paducah, KY 42003-5132
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KY-R3597 | Other | KY | LICENSE NUMBER |
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 |
|---|---|---|---|
| KY-R3597 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215078092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 ASPEN WAY",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420035132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5150 VILLAGE SQUARE DR",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420019060",
"telephone_number": "270-443-0681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRIDER",
"first_name": "LESLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "KY-R3597",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "KY-R3597",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.