Individual provider Active NPI

Cherotich Picoty Leitich, OTR/L

  • Occupational Therapist
  • Fort Worth, TX
National Provider Identifier
1417412982
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
117281 Issued in TX
Practice address
7021 Bryant Irvin Rd
Fort Worth, TX 76132-4243
Phone
(817) 332-7003
NPI assigned
Feb 8, 2019
Last updated
Feb 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 117281 TX Primary

Addresses

Primary practice location

7021 Bryant Irvin Rd
Fort Worth, TX 76132-4243

Mailing address

7021 Bryant Irvin Rd
Fort Worth, TX 76132-4243

Other identifiers 2

IdentifierTypeStateIssuer
1770972572OtherSNF
1972742815MedicaidTX

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
117281TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1417412982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7021 BRYANT IRVIN RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7021 BRYANT IRVIN RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324243",
            "telephone_number": "817-332-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITICH",
        "first_name": "CHEROTICH",
        "middle_name": "PICOTY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "117281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SNF",
            "identifier": "1770972572",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972742815",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.