Individual provider Active NPI

Martha Blodgett

  • Occupational Therapist
  • North Little Rock, AR
National Provider Identifier
1073973293
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR2900 Issued in AR
Practice address
5532 JFK Blvd
North Little Rock, AR 72116-6708
Phone
(501) 588-3211
Fax
(501) 353-2599
NPI assigned
Mar 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 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 OTR2900 AR Primary

Addresses

Primary practice location

5532 JFK Blvd
North Little Rock, AR 72116-6708

Mailing address

PO Box 333
Ward, AR 72176-0333
Phone (501) 588-3211

Other practice location 1

1500 Wilson Loop
Ward, AR 72176-8656
Phone (501) 588-3211

Other identifiers 1

IdentifierTypeStateIssuer
213653721MedicaidAR

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
OTR2900ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Therapy and Consulting Services, PA PastSince Apr 24, 2019 Accepting new patients
Beyond Boundaries, Inc Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1073973293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 333",
            "city": "WARD",
            "state": "AR",
            "postal_code": "721760333",
            "telephone_number": "501-588-3211",
            "fax_number": "501-353-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5532 JFK BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721166708",
            "telephone_number": "501-588-3211",
            "fax_number": "501-353-2599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Wilson Loop",
            "address_purpose": "LOCATION",
            "city": "Ward",
            "state": "AR",
            "postal_code": "721768656",
            "country_code": "US",
            "telephone_number": "501-588-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLODGETT",
        "first_name": "MARTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-01",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR2900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213653721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.