Active NPI
Michael R Olegario, PT
- Occupational Therapist
- Pine Bluff, AR
National Provider Identifier
1144458407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- PT1193
- Practice address
- 2915 S Hazel St
Pine Bluff, AR 71603-5008 - Phone
- (870) 535-0010
- Fax
- (870) 535-1116
- NPI assigned
- Jun 25, 2009
- Sex
- Male
- Sole proprietor
- No
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 Therapist | 225X00000X | PT1193 | AR | Primary |
Addresses
Primary practice location
2915 S Hazel St
Pine Bluff, AR 71603-5008
Mailing address
707 Eldridge Ave E
Wynne, AR 72396-4032
Phone (870) 535-0010
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 |
|---|---|---|---|
| PT1193 | AR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245888000000",
"number": "1144458407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 ELDRIDGE AVE E",
"city": "WYNNE",
"state": "AR",
"postal_code": "723964032",
"telephone_number": "870-535-0010",
"fax_number": "870-535-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2915 S HAZEL ST",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716035008",
"telephone_number": "870-535-0010",
"fax_number": "870-535-1116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLEGARIO",
"first_name": "MICHAEL",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-25",
"last_updated": "2009-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "PT1193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.