Leung S Tai, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA-1064 Issued in ID

Practice address

634 Trejo St
Rexburg, ID 83440-2579

Phone

(208) 761-0252

NPI assigned

Dec 9, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1355011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355011200000",
    "number": "1639414287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 TREJO ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402579",
            "telephone_number": "208-761-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 TREJO ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402579",
            "telephone_number": "208-761-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAI",
        "first_name": "LEUNG",
        "middle_name": "S",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-09",
        "last_updated": "2012-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ID",
            "license": "OTA-1064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Summers, DDS
• Summit Spine and Sport Chiropractic, PLLC
• Kaden Sutherland, PT
• Nicole Sutton, LCSW
• Mackenzie L Swenson, CCC-SLP
• Poh Heng Anthony Tan
• Shawn Gabriel Tan, CTRS
• Tanabell Health Services, Inc.
• Jessica Tanner, LCSW
• Tyler Reed Tarbet

• Occupational Therapy Assistant in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Occupational Therapy Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.

Verify at the official NPI Registry.