Brett Polaski, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR3924 Issued in AR

Practice address

153 E Monte Painter Dr
Fayetteville, AR 72703-4002

Phone

(479) 444-2200

NPI assigned

Dec 26, 2024

Last updated

Dec 26, 2024By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1735171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1073321832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 E SPRING ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727014223",
            "telephone_number": "337-254-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 E MONTE PAINTER DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034002",
            "telephone_number": "479-444-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLASKI",
        "first_name": "BRETT",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.