Active NPI
Leslie A Jurado, OTR
- Pediatric Occupational Therapist
- Rock Hill, SC
National Provider Identifier
1730351651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 2452
- Practice address
- 1803 Ebenezer Rd
Rock Hill, SC 29732-1189 - Phone
- (803) 620-9702
- Fax
- (803) 620-9722
- NPI assigned
- Apr 1, 2008
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 2452 | SC | Primary |
Addresses
Primary practice location
1803 Ebenezer Rd
Rock Hill, SC 29732-1189
Mailing address
1803 Ebenezer Rd
Rock Hill, SC 29732-1189
Phone (803) 620-9702
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TH1347 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2452 | SC | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connected Kidz, LLC | Pediatrics | Current | Accepting new patients |
Locations
1803 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 620-9702
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586476800000",
"number": "1730351651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1803 EBENEZER RD",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321189",
"telephone_number": "803-620-9702",
"fax_number": "803-620-9722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1803 EBENEZER RD",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297321189",
"telephone_number": "803-620-9702",
"fax_number": "803-620-9722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURADO",
"first_name": "LESLIE",
"middle_name": "A",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-01",
"last_updated": "2020-04-10",
"certification_date": "2020-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "SC",
"license": "2452",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TH1347",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.