Active NPI
Lauren A Corn, COTA
- Occupational Therapy Assistant
- West Fork, AR
National Provider Identifier
1134437882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OT-A611
- Practice address
- 365 McKnight Ave
West Fork, AR 72774-3144 - Phone
- (479) 839-3030
- Fax
- (479) 839-3045
- NPI assigned
- Sep 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OT-A611 | AR | Primary |
Addresses
Primary practice location
365 McKnight Ave
West Fork, AR 72774-3144
Mailing address
8107 Madison Ave
Kansas City, MO 64114-2231
Phone (870) 784-0821
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT-A611 | AR | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461715200000",
"number": "1134437882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8107 MADISON AVE",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641142231",
"telephone_number": "870-784-0821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 MCKNIGHT AVE",
"city": "WEST FORK",
"state": "AR",
"postal_code": "727743144",
"telephone_number": "479-839-3030",
"fax_number": "479-839-3045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORN",
"first_name": "LAUREN",
"middle_name": "A",
"name_prefix": "Miss",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-15",
"last_updated": "2016-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AR",
"license": "OT-A611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Fork, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.