Leslie Rae Childress, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP.13152 Issued in OH

Practice address

1225 Corporate Dr Ste B
Holland, OH 43528-7701

Phone

(419) 866-0555

Fax

(419) 866-0556

NPI assigned

May 9, 2013

Last updated

Aug 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Leslie Rae Roerk Former name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Med1Care Therapy Partners LLC

  • Physical Therapist
  • Holland, OH
  • NPI 1770169492
  Medicare reassignment NPD
• Med1Care, LLC

  • Home Health Agency
  • Holland, OH
  • NPI 1770958829
  NPD (past)

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1932544491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SHAWNEE RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458053583",
            "telephone_number": "419-999-2010",
            "fax_number": "419-999-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 CORPORATE DR STE B",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435287701",
            "telephone_number": "419-866-0555",
            "fax_number": "419-866-0556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Shawnee Rd",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458053529",
            "country_code": "US",
            "telephone_number": "419-999-2010 x01197",
            "fax_number": "419-999-6284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "LESLIE",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.13152",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL012011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "ROERK",
            "middle_name": "RAE",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Timothy Chapman, CDCA
• Choices Health and Wellness LLC
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• Bethany Christensen
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• Speech-Language Pathologist in Holland, OH
• Providers in Holland, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.