Individual provider Active NPI

Robin Coppock, OTRL

  • Pediatric Occupational Therapist
  • Bryant, AR
National Provider Identifier
1164560405
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OTR825 Issued in AR
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

LicenseStateTypeSpecialty
OTR825ARMDPediatric Occupational Therapist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OTR825 AR Primary

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
126978721MedicaidAR

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.

Verify at the official NPI Registry.