Active NPI
Mallory Moix, MS OTR/L
- Occupational Therapist
- Benton, AR
National Provider Identifier
1093266538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR2983
- Practice address
- 17706 Interstate 30 N
Suite 3
Benton, AR 72019-2907 - Phone
- (501) 315-4414
- NPI assigned
- Oct 19, 2016
- 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 | OTR2983 | AR | Primary |
Addresses
Primary practice location
17706 Interstate 30 N
Suite 3
Benton, AR 72019-2907
Mailing address
3930 Highway 60 E
Bigelow, AR 72016-5065
Phone (501) 504-9131
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR2983 | AR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476835200000",
"number": "1093266538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3930 HIGHWAY 60 E",
"city": "BIGELOW",
"state": "AR",
"postal_code": "720165065",
"telephone_number": "501-504-9131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17706 INTERSTATE 30 N",
"address_2": "SUITE 3",
"city": "BENTON",
"state": "AR",
"postal_code": "720192907",
"telephone_number": "501-315-4414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOIX",
"first_name": "MALLORY",
"credential": "MS OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-19",
"last_updated": "2016-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR2983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.