Nicolette Sue Mourer, OT-A

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A1950 Issued in AR

Practice address

3917 Keener LN
Harrison, AR 72601-7522

Phone

(870) 302-9277

NPI assigned

Jul 17, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Branded Equine Based Therapy Services

  • Clinic/Center
  • Harrison, AR
  • NPI 1770227555
  NPD

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1093494114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 HIGHWAY 65 S",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726017400",
            "telephone_number": "574-249-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 KEENER LN",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726017522",
            "telephone_number": "870-302-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURER",
        "first_name": "NICOLETTE",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "OT-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32002317A",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "217730",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "15631",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA19300",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5499",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A1950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winston Allen Morrison Jr., LPC-S
• Donna Sue Moshier, LPC
• Mount Carmel Physical Therapy Center, PLLC
• Mount Vista Healthcare LLC
• Mountaincrest Rehab Services
• Movement Health Solutions PA
• Keisha Mudgett, MHPP
• Nathan Dale Mulanax, D.C.
• George Myers
• Meredith Rae Myers, MSN, APRN FNP-BC

• Occupational Therapy Assistant in Harrison, AR
• Providers in Harrison, AR by specialty
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.