Individual provider Active NPI

Leah Michelle Riley

  • Occupational Therapy Assistant
  • El Dorado, AR
National Provider Identifier
1376780486
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OT-A445 Issued in AR
Practice address
266 Chapel Dr
El Dorado, AR 71730-3989
Phone
(870) 866-0758
NPI assigned
Jan 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OT-A445 AR Primary

Addresses

Primary practice location

266 Chapel Dr
El Dorado, AR 71730-3989

Mailing address

5419 Red Oak Dr
El Dorado, AR 71730-8511
Phone (870) 866-0758

Other identifiers 1

IdentifierTypeStateIssuer
162250721MedicaidAR

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

LicenseStateTypeSpecialty
OT-A445ARMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1376780486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5419 RED OAK DR",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717308511",
            "telephone_number": "870-866-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 CHAPEL DR",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717303989",
            "telephone_number": "870-866-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "LEAH",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162250721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.