Carlie Rose

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A1954 Issued in AR

Practice address

23 Parkcliff Dr
Holiday Island, AR 72631-8045

Phone

(479) 363-6422

Fax

(479) 363-6763

NPI assigned

Aug 7, 2023

Sex

Female

Sole proprietor

No

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.

• Wolf Wellness Center, PLLC

  • Rehabilitation Clinic/Center
  • Holiday Island, AR
  • NPI 1588037196
  NPD
• Spine and Sports Therapy LLC

  • Physical Therapist
  • Lowell, AR
  • NPI 1730454935
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 7, 2023.

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1114609351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PARKCLIFF DR",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726318045",
            "telephone_number": "479-363-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 PARKCLIFF DR",
            "city": "HOLIDAY ISLAND",
            "state": "AR",
            "postal_code": "726318045",
            "telephone_number": "479-363-6422",
            "fax_number": "479-363-6763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "CARLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A1954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reilly Nichols
• Peachtree Village at Holiday Island
• Jeffery L. Price, PHARM.D.
• Ptworks,P.a.
• Ana Rebeca Rodriguez, LPC
• Steve Rose, MD
• Jacquelynn Skaarup, COTA
• Stephanie Ann Spiva, COTA
• Shania Stehlik, COTA
• Gregory Michael Tancibok, LPC

• All providers in Holiday Island, AR
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.