Individual provider Active NPI

Becky Renna Williams, OTRL

  • Occupational Therapist
  • Bryant, AR
National Provider Identifier
1013069160
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR343 Issued in AR
Practice address
200 NW 4TH St
Bryant, AR 72022-3424
Phone
(501) 847-5660
Fax
(501) 847-5662
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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 OTR343 AR Primary

Addresses

Primary practice location

200 NW 4TH St
Bryant, AR 72022-3424

Mailing address

5501 Village Trce
Benton, AR 72019-9601
Phone (501) 590-7502

Other identifiers 1

IdentifierTypeStateIssuer
118135721MedicaidAR

Other names 1

  • Becky Renna Reynolds Former name

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

LicenseStateTypeSpecialty
OTR343ARMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1013069160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 VILLAGE TRCE",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720199601",
            "telephone_number": "501-590-7502",
            "fax_number": "501-847-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NW 4TH ST",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720223424",
            "telephone_number": "501-847-5660",
            "fax_number": "501-847-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BECKY",
        "middle_name": "RENNA",
        "name_prefix": "Ms.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118135721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BECKY",
            "last_name": "REYNOLDS",
            "middle_name": "RENNA",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bryant, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.