Active NPI
Leesolee Kolokollie
- Occupational Therapy Assistant
- Bradenton, FL
National Provider Identifier
1518237478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA11368
- Practice address
- 5633 25TH Street Cir E
Bradenton, FL 34203-4910 - Phone
- (941) 580-2461
- NPI assigned
- Jan 10, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA11368 | FL | Primary |
Addresses
Primary practice location
5633 25TH Street Cir E
Bradenton, FL 34203-4910
Mailing address
5633 25TH Street Cir E
Bradenton, FL 34203-4910
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTA 11368 | Other | FL | FLORIDA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA11368 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326153600000",
"number": "1518237478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5633 25TH STREET CIR E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342034910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5633 25TH STREET CIR E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342034910",
"telephone_number": "941-580-2461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLOKOLLIE",
"first_name": "LEESOLEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-10",
"last_updated": "2012-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA11368",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA",
"identifier": "OTA 11368",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.