Brenda Lee Lestock, AT/L

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

1361 Issued in OH

Practice address

1755 Rustic Timbers LN Apt 205
Prescott, AZ 86303-6902

Phone

(330) 903-1018

NPI assigned

Mar 19, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Brenda Lee Lestock Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520121600000",
    "number": "1396162079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 HILLSIDE CT",
            "city": "HOWARD",
            "state": "OH",
            "postal_code": "430288052",
            "telephone_number": "330-903-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 RUSTIC TIMBERS LN APT 205",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863036902",
            "telephone_number": "330-903-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTOCK",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "AT/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-19",
        "last_updated": "2018-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "1033",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "1361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ATHLETIC TRAINER",
            "identifier": "2255A2300X",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "LESTOCK",
            "middle_name": "LEE",
            "credential": "ATHLETIC TRAINER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Zachary Randolph Leonard, PA-C
• Cydney Lesniak
• Deborah Karen Lessard, O.T.
• Maya Lessen, NP-C
• Debra Ann Lessner, FNP
• Deeann Louise Lett Neal, OTR L
• Jessica Lee Levasseur, PA-C
• Louise Corinne Levy, LMT
• Mary Lewis, RDH
• Weston Stallard Lewis, PHARMD

• Physical Medicine & Rehabilitation Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2018; 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.