Active NPI
Marian Eades, OTR/L
- Pediatric Occupational Therapist
- Little Rock, AR
National Provider Identifier
1083717425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OTR1466
- Practice address
- 5 Remington Cove
Little Rock, AR 72204 - Phone
- (855) 556-4769
- NPI assigned
- Sep 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OTR1466 | AR | Primary |
Addresses
Primary practice location
5 Remington Cove
Little Rock, AR 72204
Mailing address
30 N. Lake Cir.
Conway, AR 72032
Phone (501) 329-6787
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 136310721 | Medicaid | AR | |
| 5U186 | Other | AR | BLUE CROSS BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTR1466 | AR | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352764800000",
"number": "1083717425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 N. LAKE CIR.",
"city": "CONWAY",
"state": "AR",
"postal_code": "72032",
"telephone_number": "501-329-6787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 REMINGTON COVE",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72204",
"telephone_number": "855-556-4769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EADES",
"first_name": "MARIAN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2012-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AR",
"license": "OTR1466",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "136310721",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5U186",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.