Active NPI
Shelia Cripps, COTA/L
- Prevention Professional
- Bentonville, AR
National Provider Identifier
1154501823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- OT-A591
- Practice address
- 1004 SE 5TH St
Bentonville, AR 72712-6032 - Phone
- (479) 254-6717
- NPI assigned
- Nov 9, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Prevention Professional | 405300000X | OT-A591 | AR | Primary |
Addresses
Primary practice location
1004 SE 5TH St
Bentonville, AR 72712-6032
Mailing address
1004 SE 5TH St
Bentonville, AR 72712-6032
Phone (479) 254-6717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154501823 | Medicaid | AR |
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-A591 | AR | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490572800000",
"number": "1154501823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1004 SE 5TH ST",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727126032",
"telephone_number": "479-254-6717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1004 SE 5TH ST",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727126032",
"telephone_number": "479-254-6717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRIPPS",
"first_name": "SHELIA",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-09",
"last_updated": "2017-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "AR",
"license": "OT-A591",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1154501823",
"state": "AR"
}
],
"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 Mar 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.