Individual provider Active NPI

Adriann Jade Watson, OTR/L

  • Occupational Therapist
  • Berryville, AR
National Provider Identifier
1063223865
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT2025-007 Issued in AR
Practice address
1004 S Main St
Berryville, AR 72616-4330
Phone
(870) 654-3869
Fax
(870) 505-2016
NPI assigned
Jan 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OT2025-007 AR Primary

Addresses

Primary practice location

1004 S Main St
Berryville, AR 72616-4330

Mailing address

2624 Highway 206 E
Harrison, AR 72601-7040
Phone (870) 754-4698

Other practice location 1

916 Goblin Dr
Harrison, AR 72601-8885
Phone (870) 654-3869

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
OT2025-007ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Services of Northwest Arkansas, LLC Multi-Specialty CurrentSince Jan 26, 2025 Accepting new patients

Locations

1004 S Main St
Berryville, AR 72616
Phone (870) 423-1077

916 Goblin Dr
Harrison, AR 72601
Phone (870) 204-5330

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1063223865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 HIGHWAY 206 E",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726017040",
            "telephone_number": "870-754-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 S MAIN ST",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164330",
            "telephone_number": "870-654-3869",
            "fax_number": "870-505-2016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 Goblin Dr",
            "address_purpose": "LOCATION",
            "city": "Harrison",
            "state": "AR",
            "postal_code": "726018885",
            "country_code": "US",
            "telephone_number": "870-654-3869",
            "fax_number": "870-505-2016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ADRIANN",
        "middle_name": "JADE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OT2025-007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berryville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.