Individual provider Active NPI

Lesley Cole Hedlund, OT

  • Occupational Therapist
  • Southlake, TX
National Provider Identifier
1912233180
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
109564 Issued in TX
Practice address
480 W Southlake Blvd Ste 111
Southlake, TX 76092-6167
Phone
(817) 778-9910
Fax
(610) 438-8094
NPI assigned
Oct 23, 2009
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 109564 TX Primary

Addresses

Primary practice location

480 W Southlake Blvd Ste 111
Southlake, TX 76092-6167

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190415000187 TX Practitioner - Occupational Therapist in Private Practice 4880935121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

480 W Southlake Blvd
Suite 111
Southlake, TX 76092-6167
Phone (817) 778-9910

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109564TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Occupational Therapist CurrentSince Sep 15, 2023 Accepting new patients
Sports Med Denton LLC Occupational Therapist CurrentSince Jan 1, 2019 Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Sep 15, 2023 Accepting new patients
Athletico LTD Occupational Therapist Current Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

5615 Colleyville Blvd
Ste 130
Colleyville, TX 76034
Phone (817) 576-0995

5510 Abrams Rd
Ste 115
Dallas, TX 75214
Phone (214) 265-9700

2318 San Jacinto Blvd
Ste 108
Denton, TX 76205
Phone (940) 202-0281

125 N MacArthur Blvd
Irving, TX 75061
Phone (972) 887-3318

480 W Southlake Blvd
Ste 111
Southlake, TX 76092
Phone (817) 778-9910

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1912233180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 W SOUTHLAKE BLVD STE 111",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926167",
            "telephone_number": "817-778-9910",
            "fax_number": "610-438-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDLUND",
        "first_name": "LESLEY",
        "middle_name": "COLE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-23",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "109564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.