Active NPI
Anita Jo Roberts, OTR/L
- Specialist
- Fayetteville, AR
National Provider Identifier
1104863752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OTR317
- Practice address
- 1760 N Woodland Ave
Fayetteville, AR 72703-2549 - Phone
- (479) 443-4420
- NPI assigned
- Jun 1, 2006
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | OTR317 | AR | Primary |
Addresses
Primary practice location
1760 N Woodland Ave
Fayetteville, AR 72703-2549
Mailing address
2435 Country LN
Springdale, AR 72762-9417
Phone (479) 361-9219
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 |
|---|---|---|---|
| OTR317 | AR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104863752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2435 COUNTRY LN",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727629417",
"telephone_number": "479-361-9219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1760 N WOODLAND AVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727032549",
"telephone_number": "479-443-4420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "ANITA",
"middle_name": "JO",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-01",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AR",
"license": "OTR317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.