Individual provider Active NPI

Lauren Vavra, MS OTR/L

  • Pediatric Occupational Therapist
  • Bentonville, AR
National Provider Identifier
1134435902
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT-1067 Issued in AR
Practice address
500 Tiger Blvd
Bentonville, AR 72712-4208
Phone
(501) 317-7880
NPI assigned
Aug 31, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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 OT-1067 AR Primary

Addresses

Primary practice location

500 Tiger Blvd
Bentonville, AR 72712-4208

Mailing address

513 S Dodson Rd
Apt. W3
Rogers, AR 72758-7393
Phone (501) 317-7880

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT-1067ARMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dream Big Pediatric Therapies Past 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": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1134435902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 S DODSON RD",
            "address_2": "APT. W3",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727587393",
            "telephone_number": "501-317-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 TIGER BLVD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124208",
            "telephone_number": "501-317-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVRA",
        "first_name": "LAUREN",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AR",
            "license": "OT-1067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.