Individual provider Active NPI

Tanner Wilson Jarrett, OTA

  • Occupational Therapy Assistant
  • Jonesboro, AR
National Provider Identifier
1124445358
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
O-T1407 Issued in AR
Practice address
3114 Fox Road Suite a
Jonesboro, AR 72404
Phone
(870) 933-9294
Fax
(870) 933-9293
NPI assigned
Mar 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X O-T1407 AR Primary
Occupational Therapy Assistant 224Z00000X

Addresses

Primary practice location

3114 Fox Road Suite a
Jonesboro, AR 72404

Mailing address

PO Box 16011
Jonesboro, AR 72403
Phone (870) 926-7725

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
O-T1407ARMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thera-Play Pediatric Therapy Associates Past Accepting new patients
Thera-Play Pediatric Therapy Associates Past Accepting new patients

Organizations & group practices 2

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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1124445358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16011",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72403",
            "telephone_number": "870-926-7725",
            "fax_number": "870-933-9293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 FOX ROAD SUITE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72404",
            "telephone_number": "870-933-9294",
            "fax_number": "870-933-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRETT",
        "first_name": "TANNER",
        "middle_name": "WILSON",
        "name_prefix": "Mr.",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "O-T1407",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.