Individual provider Active NPI

Robin M Leuchtag

  • Occupational Therapist
  • Chardon, OH
National Provider Identifier
1508592312
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT2210 Issued in OH
Practice address
501 Chardon Windsor Rd
Chardon, OH 44024-8944
Phone
(216) 401-4587
NPI assigned
Jul 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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 OT2210 OH Primary

Addresses

Primary practice location

501 Chardon Windsor Rd
Chardon, OH 44024-8944

Mailing address

12501 Harold Dr
Chesterland, OH 44026-2430
Phone (216) 401-4587

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT2210OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Aug 9, 2022 Accepting new patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Aug 9, 2022 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

501 Chardon Windsor Rd
Chardon, OH 44024
Phone (440) 286-2277

Organizations & group practices 3

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": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1508592312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 HAROLD DR",
            "city": "CHESTERLAND",
            "state": "OH",
            "postal_code": "440262430",
            "telephone_number": "216-401-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CHARDON WINDSOR RD",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440248944",
            "telephone_number": "216-401-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUCHTAG",
        "first_name": "ROBIN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT2210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.