Active NPI
Robin Coppock, OTRL
- Pediatric Occupational Therapist
- Bryant, AR
National Provider Identifier
1164560405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OTR825
- Practice address
- 200 NW 4TH St
Bryant, AR 72022-3424 - Phone
- (501) 847-5600
- NPI assigned
- Feb 1, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| OTR825 | AR | MD | Pediatric Occupational Therapist |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OTR825 | AR | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
200 NW 4TH St
Bryant, AR 72022-3424
Mailing address
9778 Springhill Farms Dr
Alexander, AR 72002-8998
Phone (501) 588-7674
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126978721 | Medicaid | AR |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 3, 2010.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275523200000",
"number": "1164560405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9778 SPRINGHILL FARMS DR",
"city": "ALEXANDER",
"state": "AR",
"postal_code": "720028998",
"telephone_number": "501-588-7674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 NW 4TH ST",
"city": "BRYANT",
"state": "AR",
"postal_code": "720223424",
"telephone_number": "501-847-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPPOCK",
"first_name": "ROBIN",
"name_prefix": "Mrs.",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-01",
"last_updated": "2010-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AR",
"license": "OTR825",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126978721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bryant, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.