Individual provider Active NPI

Steven Robert Garrison

  • Physical Therapy Assistant
  • Jonesboro, AR
National Provider Identifier
1194370080
Registry record updated Jan 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4221 Issued in AR
Practice address
1699 Red Wolf Blvd Ste H
Jonesboro, AR 72401-5453
Phone
(870) 336-0021
NPI assigned
Aug 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 4221 AR Primary

Addresses

Primary practice location

1699 Red Wolf Blvd Ste H
Jonesboro, AR 72401-5453

Mailing address

1699 Red Wolf Blvd Ste H
Jonesboro, AR 72401-5453
Phone (870) 336-0021

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
4221ARMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1194370080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 RED WOLF BLVD STE H",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015453",
            "telephone_number": "870-336-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 RED WOLF BLVD STE H",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015453",
            "telephone_number": "870-336-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "STEVEN",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-07",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "4221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; 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.