Individual provider Active NPI

Leslie Macon O'Bryan, O.T.R./L., C.H.T.

  • Hand Occupational Therapist
  • Oxford, MS
National Provider Identifier
1487733473
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT1383 Issued in MS
Practice address
1204 Office Park Dr Ste C
Oxford, MS 38655-3597
Phone
(662) 281-0022
Fax
(662) 281-0067
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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 MS
Hand Occupational Therapist 225XH1200X OT1383 MS Primary

Addresses

Primary practice location

1204 Office Park Dr Ste C
Oxford, MS 38655-3597

Mailing address

1204 Office Park Dr Ste C
Oxford, MS 38655-3597
Phone (662) 281-0022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150915002291 MS Practitioner - Occupational Therapist in Private Practice 8426297987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Hand TherapyGroup PAC ID 4789908138, 2 clinicians

Practice addresses (Care Compare)

1204 Office Park Dr
Suite C
Oxford, MS 38655-3597
Phone (662) 281-0022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT1383MSMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Hand Therapy Occupational Therapist CurrentSince Jun 18, 2014 Accepting new patients
North Mississippi Hand Therapy Occupational Therapist CurrentSince Dec 1, 2014 Accepting new patients

Locations

187 Highway 51 S
Batesville, MS 38606
Phone (662) 281-0022

2714 West Oxford Loop
Ste 164
Oxford, MS 38655
Phone (662) 232-8949

1204 Office Park Dr
#C
Oxford, MS 38655
Phone (662) 281-0022

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1487733473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 OFFICE PARK DR STE C",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553597",
            "telephone_number": "662-281-0022",
            "fax_number": "662-281-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 OFFICE PARK DR STE C",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553597",
            "telephone_number": "662-281-0022",
            "fax_number": "662-281-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRYAN",
        "first_name": "LESLIE",
        "middle_name": "MACON",
        "credential": "O.T.R./L., C.H.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MS",
            "license": "OT1383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.