Active NPI
Leslie Shannon Oneill
- Pediatric Physical Therapist
- Lawrenceville, GA
National Provider Identifier
1306912803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT005241
- Practice address
- 318 West Pike Street
Suite 104
Lawrenceville, GA 30045 - Phone
- (678) 377-2833
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT005241 | GA | Primary |
Addresses
Primary practice location
318 West Pike Street
Suite 104
Lawrenceville, GA 30045
Mailing address
525 Overbrook Dr.
Atlanta, GA 30318
Phone (404) 788-7416
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10037601 | Other | GA | AMERIGROUP- AAKTS |
| 307923 | Other | GA | WELLCARE- AAKTS |
| 00838362A | Medicaid | GA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT005241 | GA | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| All About Kids Therapy Services, Inc. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Physical Therapist
- Lawrenceville, GA
- NPI 1992997563
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1306912803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 OVERBROOK DR.",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30318",
"telephone_number": "404-788-7416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 WEST PIKE STREET",
"address_2": "SUITE 104",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "30045",
"telephone_number": "678-377-2833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ONEILL",
"first_name": "LESLIE",
"middle_name": "SHANNON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "GA",
"license": "PT005241",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP- AAKTS",
"identifier": "10037601",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE- AAKTS",
"identifier": "307923",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00838362A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.