Active NPI
Leslie Ellen Gray, OCCUPATIONAL THERAPY
- Pediatric Occupational Therapist
- Frederick, MD
National Provider Identifier
1851574982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 05971
- Practice address
- 350 Montevue LN
Frederick, MD 21702-8214 - Phone
- (301) 600-7413
- Fax
- (301) 600-3280
- NPI assigned
- Dec 12, 2007
- Last updated
- Oct 31, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurorehabilitation Occupational Therapist | 225XN1300X | 05971 | MD | |
| Pediatric Occupational Therapist | 225XP0200X | 05971 | MD | Primary |
Addresses
Primary practice location
350 Montevue LN
Frederick, MD 21702-8214
Mailing address
187 Thomas Johnson Dr
6
Frederick, MD 21702-4503
Phone (301) 663-1157
Other practice location 1
187 Thomas Johnson Dr
6
Frederick, MD 21702-4503
Phone (301) 663-1157
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 |
|---|---|---|---|
| 05971 | MD | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amber Hill Physical Therapy, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Frederick, MD
- NPI 1548290224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540944000000",
"number": "1851574982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "187 THOMAS JOHNSON DR",
"address_2": "6",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217024503",
"telephone_number": "301-663-1157",
"fax_number": "301-663-1229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 MONTEVUE LN",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217028214",
"telephone_number": "301-600-7413",
"fax_number": "301-600-3280"
}
],
"practiceLocations": [
{
"address_1": "187 Thomas Johnson Dr",
"address_2": "6",
"address_purpose": "LOCATION",
"city": "Frederick",
"state": "MD",
"postal_code": "217024503",
"country_code": "US",
"telephone_number": "301-663-1157",
"fax_number": "301-663-1229",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRAY",
"first_name": "LESLIE",
"middle_name": "ELLEN",
"credential": "OCCUPATIONAL THERAPY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-12",
"last_updated": "2018-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "MD",
"license": "05971",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MD",
"license": "05971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.