Leslie D Edgecomb, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31001170A Issued in IN

Practice address

5949 W Raymond St
Indianapolis, IN 46241-4348

Phone

(317) 390-5575

Fax

(317) 486-2189

NPI assigned

Apr 3, 2006

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 identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1780646042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5949 W RAYMOND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462414348",
            "telephone_number": "317-390-5575",
            "fax_number": "317-486-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGECOMB",
        "first_name": "LESLIE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31001170A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01023463",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200117530",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID",
            "identifier": "000000213935",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uyai-Abasi Edet
• Edge Medical Services
• Edge Medical Services
• Edge Medical Services
• Kelly Jean Edge, CGC
• Karen Sue Edgerson, R.PH., PH.D.
• Randall Kirk Edgerson, PHARM D
• Tyler Edlin, PHARMD
• Jacob Stafford Edmisson, MD
• Sandra Marie Edmond, MS,RD,CD

• Occupational Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.