Individual provider Active NPI

Emmanuelle Talib, OTD, R/L

  • Occupational Therapist
  • Jonesboro, AR
National Provider Identifier
1013551753
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR3329 Issued in AR
Practice address
151 Southwest Dr
Jonesboro, AR 72401-5828
Phone
(870) 932-0090
Fax
(870) 932-9336
NPI assigned
Nov 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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 OTR3329 AR Primary

Addresses

Primary practice location

151 Southwest Dr
Jonesboro, AR 72401-5828

Mailing address

1420 Elmwood PL
Jonesboro, AR 72401-5036
Phone (870) 273-8698

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
OTR3329ARMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1013551753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 ELMWOOD PL",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015036",
            "telephone_number": "870-273-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SOUTHWEST DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015828",
            "telephone_number": "870-932-0090",
            "fax_number": "870-932-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALIB",
        "first_name": "EMMANUELLE",
        "credential": "OTD, R/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.