Clara Ann Ellenburg, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A2084 Issued in AR

Practice address

447 S Country Club Rd
Osceola, AR 72370-4207

Phone

(870) 563-0199

NPI assigned

Dec 30, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• First Step Arkansas, LLC

  • Pediatric Physical Therapist
  • Osceola, AR
  • NPI 1205566577
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1154130631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2578 GREENE 721 RD",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724507909",
            "telephone_number": "870-335-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 S COUNTRY CLUB RD",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723704207",
            "telephone_number": "870-563-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBURG",
        "first_name": "CLARA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A2084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. L B Keller, Optometrist, PLC
• East Arkansas Emergency Physicians, PLLC
• Douglas Lee Echols Jr.
• James Raynard Edwards, M.ED.
• Lacie Edwards
• Stephan Wayne Elrod, MHPP
• Malissa Ephlin
• Catherine Lowery Everhart, ECDT
• Roxanne J Everhart, LAC
• Nicole Evers, MS, CCC-SLP

• All providers in Osceola, AR
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.