Alexis Boatman

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A1977 Issued in AR

Practice address

1805 Executive SQ
Jonesboro, AR 72401-6086

Phone

(870) 336-6492

Fax

(870) 455-0271

NPI assigned

May 28, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eighty-Twenty Learning for Asd, LLC

  • Behavior Analyst
  • Bono, AR
  • NPI 1902573496
  NPD (past)

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1013757061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 EXECUTIVE SQ",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016086",
            "telephone_number": "870-336-6492",
            "fax_number": "870-455-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 EXECUTIVE SQ",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016086",
            "telephone_number": "870-336-6492",
            "fax_number": "870-455-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATMAN",
        "first_name": "ALEXIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A1977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bloom Pediatric Therapy Services Inc
• Bloom Therapy
• Rodney T Blumingburg
• Paul S Blumreich, CRNA
• Nathan Boak
• Melody Ann Boatright, QBHP
• Brittany Bobbitt
• Gloria Bobo
• Charles Boeckmann
• Destiny Bogard

• Occupational Therapy Assistant in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.