Active NPI
Leah Paule Walker, COTA/L
- Occupational Therapy Assistant
- South Bend, IN
National Provider Identifier
1407120546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 32002098A
- Practice address
- 23060 Benson CT
South Bend, IN 46628-9040 - Phone
- (574) 400-3581
- NPI assigned
- Mar 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 32002098A | IN | Primary |
| Occupational Therapy Assistant | 224Z00000X | OTA001549 | GA | |
| Occupational Therapy Assistant | 224Z00000X | 211599 | TX |
Addresses
Primary practice location
23060 Benson CT
South Bend, IN 46628-9040
Mailing address
216 Semel Dr NW
Unit #378
Atlanta, GA 30309-1956
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 |
|---|---|---|---|
| OTA001549 | GA | MD | Occupational Therapy Assistant |
| 32002098A | IN | MD | Occupational Therapy Assistant |
| 211599 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374019200000",
"number": "1407120546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 SEMEL DR NW",
"address_2": "UNIT #378",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303091956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23060 BENSON CT",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466289040",
"telephone_number": "574-400-3581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "LEAH",
"middle_name": "PAULE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-07",
"last_updated": "2013-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IN",
"license": "32002098A",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "GA",
"license": "OTA001549",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "211599",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.