Individual provider Active NPI

Amanda Locknar

  • Occupational Therapist
  • Bentonville, AR
National Provider Identifier
1093538829
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR4008 Issued in AR
Practice address
3108 SW Regency Pkwy Ste 5
Bentonville, AR 72712-7753
Phone
(479) 430-1023
Fax
(479) 668-2257
NPI assigned
Oct 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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 OTR4008 AR Primary

Addresses

Primary practice location

3108 SW Regency Pkwy Ste 5
Bentonville, AR 72712-7753

Mailing address

3108 SW Regency Pkwy Ste 5
Bentonville, AR 72712-7753
Phone (479) 430-1023

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
OTR4008ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fusion Therapy Center, LLC Occupational Therapist CurrentSince Jan 31, 2023 Accepting new patients

Locations

3108 SW Regency Pkwy
Ste 5
Bentonville, AR 72712
Phone (479) 252-3321

3201 SW Regency Pkwy
Ste 5
Bentonville, AR 72712
Phone (479) 252-3321

Organizations & group practices 1

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": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1093538829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 SW REGENCY PKWY STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127753",
            "telephone_number": "479-430-1023",
            "fax_number": "479-668-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 SW REGENCY PKWY STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127753",
            "telephone_number": "479-430-1023",
            "fax_number": "479-668-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKNAR",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR4008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.