Active NPI
Nicole Elizabeth Letendre, OTR,L
- Occupational Therapist
- Johnston, IA
National Provider Identifier
1700903788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 103272
- Practice address
- 5406 Merle Hay Road
Johnston, IA 50131 - Phone
- (612) 747-8032
- NPI assigned
- Mar 23, 2007
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225X00000X | 103272 | MN | Primary |
Addresses
Primary practice location
5406 Merle Hay Road
Johnston, IA 50131
Mailing address
2005 SW 35TH St
#1202
Ankeny, IA 50023-5904
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103272 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370995200000",
"number": "1700903788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 SW 35TH ST",
"address_2": "#1202",
"city": "ANKENY",
"state": "IA",
"postal_code": "500235904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5406 MERLE HAY ROAD",
"city": "JOHNSTON",
"state": "IA",
"postal_code": "50131",
"telephone_number": "612-747-8032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LETENDRE",
"first_name": "NICOLE",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "OTR,L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2013-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "103272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnston, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.