Active NPI
Pam Page
- Occupational Therapist
- Green Forest, AR
National Provider Identifier
1104148766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 516 Cottonwood LN
Green Forest, AR 72638-2360 - Phone
- (870) 350-1173
- NPI assigned
- Feb 24, 2010
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
516 Cottonwood LN
Green Forest, AR 72638-2360
Mailing address
PO Box 761
Berryville, AR 72616-0761
Phone (870) 350-1173
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT2996 | Other | PHYSICAL THERAPIST |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1104148766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 761",
"city": "BERRYVILLE",
"state": "AR",
"postal_code": "726160761",
"telephone_number": "870-350-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 COTTONWOOD LN",
"city": "GREEN FOREST",
"state": "AR",
"postal_code": "726382360",
"telephone_number": "870-350-1173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "PAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-24",
"last_updated": "2010-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPIST",
"identifier": "PT2996",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Forest, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.