Individual provider Active NPI

Leita Meredith Stethen, OTR/L

  • Occupational Therapist
  • Bowling Green, KY
National Provider Identifier
1306004668
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
134360 Issued in KY
Practice address
1053 Lovers LN Ste a
Bowling Green, KY 42103-7166
Phone
(502) 633-1007
Fax
(502) 805-1511
NPI assigned
May 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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 134360 KY Primary

Addresses

Primary practice location

1053 Lovers LN Ste a
Bowling Green, KY 42103-7166

Mailing address

299 Timberwood Dr
Smiths Grove, KY 42171-8244
Phone (270) 597-9723

Other practice location 1

299 Timberwood Dr
Smiths Grove, KY 42171-8244
Phone (270) 597-9723

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

LicenseStateTypeSpecialty
R1044KYMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1306004668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 TIMBERWOOD DR",
            "city": "SMITHS GROVE",
            "state": "KY",
            "postal_code": "421718244",
            "telephone_number": "270-597-9723",
            "fax_number": "270-597-9723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 LOVERS LN STE A",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037166",
            "telephone_number": "502-633-1007",
            "fax_number": "502-805-1511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "299 Timberwood Dr",
            "address_purpose": "LOCATION",
            "city": "Smiths Grove",
            "state": "KY",
            "postal_code": "421718244",
            "country_code": "US",
            "telephone_number": "270-597-9723",
            "fax_number": "270-597-9723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STETHEN",
        "first_name": "LEITA",
        "middle_name": "MEREDITH",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "134360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.