Leah Mashburn, MOT/ OTR,L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

5485 Issued in OK

Practice address

1605 S Eucalyptus Ave Ste 200
Broken Arrow, OK 74012-5996

Phone

(918) 608-1212

Fax

(918) 289-2606

NPI assigned

Sep 22, 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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Spot for Kids

  • Speech-Language Pathologist
  • Broken Arrow, OK
  • NPI 1851715395
  NPD (past)

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1861008195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 S EUCALYPTUS AVE STE 200",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125996",
            "telephone_number": "918-608-1212",
            "fax_number": "918-289-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 S EUCALYPTUS AVE STE 200",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125996",
            "telephone_number": "918-608-1212",
            "fax_number": "918-289-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHBURN",
        "first_name": "LEAH",
        "credential": "MOT/ OTR,L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OK",
            "license": "5485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION",
            "identifier": "5485",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.thespotforkids@gmail.com",
            "affiliation": "Y",
            "endpointDescription": "Web Address",
            "affiliationName": "The SPOT for kids",
            "address_1": "1605 S Eucalyptus Ave Ste 200",
            "city": "Broken Arrow",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740125996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andy Ty Martinez, OTR/L
• Elizabeth Sue Martinez
• Irving De Jesus Martinez I
• Lucina Denise Martinez
• Sthembiso Mitchelle Maseko
• Athena C Mason, D.O.
• Nicole Paola Mathes, MD
• James V Mathews
• Leah Gail Mathias, FNP
• Shelby Nichole Mathis

• Pediatric Occupational Therapist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Pediatric Occupational Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.