Individual provider Active NPI

Melissa Rae Dawn Huddleston, OT

  • Occupational Therapist
  • North Little Rock, AR
National Provider Identifier
1114569332
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR3331 Issued in AR
Practice address
4901 Northshore Dr
North Little Rock, AR 72118-5293
Phone
(501) 791-3331
NPI assigned
Oct 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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 OTR3331 AR Primary

Addresses

Primary practice location

4901 Northshore Dr
North Little Rock, AR 72118-5293

Mailing address

2740 College Ave
Conway, AR 72034-6141
Phone (501) 329-5459

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
OTR3331ARMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1114569332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346141",
            "telephone_number": "501-329-5459",
            "fax_number": "501-327-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 NORTHSHORE DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185293",
            "telephone_number": "501-791-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTON",
        "first_name": "MELISSA",
        "middle_name": "RAE DAWN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.