Individual provider Active NPI

Leslie Anderson Taylor, OTR

  • Occupational Therapist
  • Atlanta, GA
National Provider Identifier
1447502901
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
115029 Issued in TX
Practice address
3007 Paces Lake Dr SE
Atlanta, GA 30339-4263
Phone
(404) 547-7058
NPI assigned
Oct 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 115029 TX Primary
Occupational Therapist 225X00000X OT006184 GA

Addresses

Primary practice location

3007 Paces Lake Dr SE
Atlanta, GA 30339-4263

Mailing address

3007 Paces Lake Dr SE
Atlanta, GA 30339-4263
Phone (404) 547-7058

Other identifiers 2

IdentifierTypeStateIssuer
207164901MedicaidTX
149984001MedicaidTX

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
OT006184GAMDOccupational Therapist
115029TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1447502901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 PACES LAKE DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394263",
            "telephone_number": "404-547-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 PACES LAKE DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394263",
            "telephone_number": "404-547-7058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "LESLIE",
        "middle_name": "ANDERSON",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "115029",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006184",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207164901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149984001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.