NPIMap

Organization Active NPI

Line Leader Pediatric Therapy, PLLC

  • Pediatric Occupational Therapist
  • Austin, TX
National Provider Identifier
1245462639
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
109863 Issued in TX
Legal business name
LINE LEADER PEDIATRIC THERAPY, PLLC
Practice address
3303 Northland Dr
Suite 214
Austin, TX 78731-4945
Phone
(512) 619-0303
Fax
(512) 291-2666
NPI assigned
Aug 18, 2009
Last updated
Feb 23, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Authorized official

Name
Sharon A Wisnieski, MS-OTRNPI 1750539417
Title
Occupational Therapist
Phone
(512) 619-0303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 109863 TX
Neurorehabilitation Occupational Therapist 225XN1300X 109863 TX
Pediatric Occupational Therapist 225XP0200X 109863 TX Primary

Addresses

Primary practice location

3303 Northland Dr
Suite 214
Austin, TX 78731-4945

Mailing address

12928 Bloomfield Hills LN
Austin, TX 78732-2066
Phone (512) 619-0303

National Provider Directory

National Provider Directory

Locations

3303 Northland Dr
Ste 214
Austin, TX 78731
Phone (512) 569-9319

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298419200000",
    "number": "1245462639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12928 BLOOMFIELD HILLS LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787322066",
            "telephone_number": "512-619-0303",
            "fax_number": "512-291-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 NORTHLAND DR",
            "address_2": "SUITE 214",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314945",
            "telephone_number": "512-619-0303",
            "fax_number": "512-291-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINE LEADER PEDIATRIC THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2011-02-23",
        "status": "A",
        "authorized_official_last_name": "WISNIESKI",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "512-619-0303",
        "authorized_official_credential": "MS-OTR"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "109863",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "TX",
            "license": "109863",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "109863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.