Individual provider Active NPI

Bridget Ann Herndon Lee, OTR/L

  • Occupational Therapist
  • Coeur D Alene, ID
National Provider Identifier
1447844949
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-2320 Issued in ID
Practice address
411 W Haycraft Ave Ste 1
Coeur D Alene, ID 83815-8105
Phone
(208) 664-2468
NPI assigned
Feb 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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 OT-2320 ID Primary

Addresses

Primary practice location

411 W Haycraft Ave Ste 1
Coeur D Alene, ID 83815-8105

Mailing address

411 W Haycraft Ave Ste D1
Coeur D Alene, ID 83815-8104
Phone (208) 664-2468

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-2320IDMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1447844949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W HAYCRAFT AVE STE D1",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158104",
            "telephone_number": "208-664-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W HAYCRAFT AVE STE 1",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158105",
            "telephone_number": "208-664-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON LEE",
        "first_name": "BRIDGET",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-2320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.