John Brian Leclerc, OTR/L
Individual provider Active NPI Occupational Therapist · Grafton, ND
NPI 1326513482 · NPPES record last updated Jan 12, 2023
Key facts
- NPI
- 1326513482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 1648 (ND)
- Practice address
- 816 W Midway Dr
Grafton, ND 58237-7501 - Phone
- (701) 352-4545
- NPI assigned
- Oct 4, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Life Skills and Transition Center
Practice addresses (Care Compare)
701 W 6TH St
Grafton, ND 58237-1379
Phone (701) 352-4200
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230324002472 | ND | Practitioner - Occupational Therapist in Private Practice | 1557735990 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105770 | MN | MD | Occupational Therapist |
| 1648 | ND | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Skills and Transition Center | Current |
Accepting new patients | |
| Life Skills and Transition Center | Current |
Accepting new patients |
Locations
701 W 6th St
Grafton, ND 58237
Phone (701) 352-2574
816 W Midway Dr
Grafton, ND 58237
Phone (701) 352-4200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 105770 | MN | |
| Occupational Therapist | 225X00000X | 1648 | ND | Yes |
Addresses
Primary practice location
816 W Midway Dr
Grafton, ND 58237-7501
Mailing address
816 W Midway Dr
Grafton, ND 58237-7501
Phone (701) 352-4545
Other providers in Grafton, ND
- Karly Koenig
- Paul Douglas Kolstoe
- Anthony James Kotnik
- Lon Kratochvil
- Kelly Larson
- Tammy Rae Lee
- Lyndsey Rae Leehan
- Life Skills and Transition Center
- Life Skills and Transition Center
- Life Skills and Transition Center
All providers in Grafton, ND · Occupational Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.