Individual provider Active NPI

Leeanne M Beasley

  • Occupational Therapist
  • Brandon, MS
National Provider Identifier
1912454281
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT2110 Issued in MS
Practice address
172 Regatta Dr
Brandon, MS 39047-7046
Phone
(601) 503-6112
NPI assigned
Sep 5, 2016
Last updated
Dec 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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 OT2110 MS Primary

Addresses

Primary practice location

172 Regatta Dr
Brandon, MS 39047-7046

Mailing address

102 Brisco St
Madison, MS 39110-4601

Other names 1

  • Leeanne Chandler Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181205000744 MS Practitioner - Occupational Therapist in Private Practice 5193069961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inmotion Rehab, LLCGroup PAC ID 8921300575, 8 clinicians

Practice addresses (Care Compare)

5411 I 55
Jackson, MS 39206-3616
Phone (769) 216-3288

585 E Beasley Rd
Jackson, MS 39206-3044
Phone (769) 216-3288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT2110MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inmotion Rehab LLC PastSince Jan 5, 2020 Accepting new patients

Organizations & group practices 2

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": "1473033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1912454281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BRISCO ST",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391104601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 REGATTA DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477046",
            "telephone_number": "601-503-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "LEEANNE",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-05",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT2110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEEANNE",
            "last_name": "CHANDLER",
            "credential": "OT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.