Individual provider Active NPI

Leila Shlosser

  • Physical Therapist
  • South Daytona, FL
National Provider Identifier
1629360292
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
OT01278 Issued in RI
Practice address
917 Beville Rd
Ste G
South Daytona, FL 32119-1712
Phone
(800) 330-7711
Fax
(866) 426-2811
NPI assigned
May 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X OT01278 RI Primary

Addresses

Primary practice location

917 Beville Rd
Ste G
South Daytona, FL 32119-1712

Mailing address

49 Blue Ridge Rd
Chittenden, VT 05737-9829

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
OT01278RIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1629360292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 BLUE RIDGE RD",
            "city": "CHITTENDEN",
            "state": "VT",
            "postal_code": "057379829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 BEVILLE RD",
            "address_2": "STE G",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191712",
            "telephone_number": "800-330-7711",
            "fax_number": "866-426-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHLOSSER",
        "first_name": "LEILA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "OT01278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; 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.