Individual provider Active NPI

Lesli Ann Seyfert, COTA

  • Occupational Therapy Assistant
  • Paxton, IL
National Provider Identifier
1639309354
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057002480 Issued in IL
Practice address
450 E Fulton St
Paxton, IL 60957-1716
Phone
(217) 379-2408
NPI assigned
Jul 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057002480 IL Primary

Addresses

Primary practice location

450 E Fulton St
Paxton, IL 60957-1716

Mailing address

1207 Muirfield PT
Champaign, IL 61822-8567
Phone (217) 721-3120

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
057002480ILMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1639309354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 MUIRFIELD PT",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618228567",
            "telephone_number": "217-721-3120",
            "fax_number": "217-379-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E FULTON ST",
            "city": "PAXTON",
            "state": "IL",
            "postal_code": "609571716",
            "telephone_number": "217-379-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYFERT",
        "first_name": "LESLI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057002480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paxton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.