Active NPI
Mindy Elaine Carroll, MS, OTR/L
- Occupational Therapist
- North Little Rock, AR
National Provider Identifier
1184880411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR2037
- Practice address
- 2200 Poplar St.
North Little Rock, AR 72115-0687 - Phone
- (501) 771-8093
- Fax
- (501) 771-8090
- NPI assigned
- Aug 6, 2008
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTR2037 | AR | Primary |
Addresses
Primary practice location
2200 Poplar St.
North Little Rock, AR 72115-0687
Mailing address
2200 Poplar St.
P.O. Box 687
North Little Rock, AR 72115-0687
Phone (501) 771-8093
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 159610721 | Medicaid | AR | |
| 5Y540 | Other | AR | BLUE CROSS |
Other names 1
- Mindy Elaine Ryals
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR2037 | AR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pulaski County Tri-District Early Childhood Program | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- North Little Rock, AR
- NPI 1194869271
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217980800000",
"number": "1184880411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 POPLAR ST.",
"address_2": "P.O. BOX 687",
"city": "NORTH LITTLE ROCK",
"state": "AR",
"postal_code": "721150687",
"telephone_number": "501-771-8093",
"fax_number": "501-771-8090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 POPLAR ST.",
"city": "NORTH LITTLE ROCK",
"state": "AR",
"postal_code": "721150687",
"telephone_number": "501-771-8093",
"fax_number": "501-771-8090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "MINDY",
"middle_name": "ELAINE",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-06",
"last_updated": "2008-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR2037",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "159610721",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "5Y540",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MINDY",
"last_name": "RYALS",
"middle_name": "ELAINE",
"credential": "MS, OTR/L",
"code": "1",
"type": "Former Name"
}
]
}Other providers in North Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.