Individual provider Active NPI

Susan R Bates, OT

  • Pediatric Occupational Therapist
  • Little Rock, AR
National Provider Identifier
1124166020
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OTR1520 Issued in AR
Practice address
11900 Kanis Rd
Ste. D-2
Little Rock, AR 72211-3733
Phone
(501) 687-0851
Fax
(501) 687-0853
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OTR1520 AR Primary

Addresses

Primary practice location

11900 Kanis Rd
Ste. D-2
Little Rock, AR 72211-3733

Mailing address

11900 Kanis Rd
Ste. D-2
Little Rock, AR 72211-3733
Phone (501) 687-0851

Other identifiers 1

IdentifierTypeStateIssuer
5X525OtherARBLUE CROSS BLUE SHIELD

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Associates Physical Therapy and Pain Management PastSince Oct 3, 2018 Accepting new patients

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124166020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 KANIS RD",
            "address_2": "STE. D-2",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113733",
            "telephone_number": "501-687-0851",
            "fax_number": "501-687-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 KANIS RD",
            "address_2": "STE. D-2",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113733",
            "telephone_number": "501-687-0851",
            "fax_number": "501-687-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AR",
            "license": "OTR1520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5X525",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.