Leslie Keller, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

000393 Issued in MO

Practice address

416 S High St
Butler, MO 64730-1827

Phone

(660) 679-6158

NPI assigned

Aug 12, 2016

Last updated

Aug 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Leslie Blankenship Former name

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": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1659825172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 S HIGH ST",
            "city": "BUTLER",
            "state": "MO",
            "postal_code": "647301827",
            "telephone_number": "660-679-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 S HIGH ST",
            "city": "BUTLER",
            "state": "MO",
            "postal_code": "647301827",
            "telephone_number": "660-679-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "LESLIE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "000393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "BLANKENSHIP",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• John Allen Keough, M.A.
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• Kamille Baker Konold, RPT
• Aida G Lawrence, CRNA

• Occupational Therapy Assistant in Butler, MO
• Providers in Butler, MO by specialty
• Occupational Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.