Leslie Ann Showalter

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

6720 Tampa Ave
Reseda, CA 91335-5014

Phone

(818) 781-1073

NPI assigned

Oct 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Leslie Ann Hale Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1760089122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 TAMPA AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913355014",
            "telephone_number": "818-781-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 TAMPA AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913355014",
            "telephone_number": "818-781-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWALTER",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALFRESH",
            "identifier": "5077190275789739",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "909258752",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94486299F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "HALE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Rehabilitation Practitioner in Reseda, CA
• Providers in Reseda, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.

Verify at the official NPI Registry.