Active NPI
Kelly C Yates
- Occupational Therapist
- Rogers, AR
National Provider Identifier
1093047649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- O-T1004
- Practice address
- 1501 Rainbow Rd
Rogers, AR 72758-1481 - Phone
- (479) 521-8326
- Fax
- (479) 521-5439
- NPI assigned
- Feb 8, 2010
- Last updated
- Feb 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | O-T1004 | AR | Primary |
Addresses
Primary practice location
1501 Rainbow Rd
Rogers, AR 72758-1481
Mailing address
1501 Rainbow Rd
Rogers, AR 72758-1481
Phone (479) 521-8326
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 |
|---|---|---|---|
| O-T1004 | AR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265587200000",
"number": "1093047649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 RAINBOW RD",
"city": "ROGERS",
"state": "AR",
"postal_code": "727581481",
"telephone_number": "479-521-8326",
"fax_number": "479-521-5439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 RAINBOW RD",
"city": "ROGERS",
"state": "AR",
"postal_code": "727581481",
"telephone_number": "479-521-8326",
"fax_number": "479-521-5439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YATES",
"first_name": "KELLY",
"middle_name": "C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-08",
"last_updated": "2010-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "O-T1004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.