Carly Michelle Woodyard, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR3606 Issued in AR

Practice address

2808 Fox Meadow Lane
Jonesboro, AR 72404-9346

Phone

(870) 335-2240

Fax

(870) 931-4457

NPI assigned

Nov 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carly Michelle Matteson Former name

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tracy Jones Physical Therapy Services, P.a.

  • Physical Therapy Clinic/Center
  • Jonesboro, AR
  • NPI 1346473139
  Medicare reassignment NPD
• Miracle Kids Success Academy

  • Speech-Language Pathologist
  • Jonesboro, AR
  • NPI 1184945701

  Occupational Therapist

  NPD (past)
• The Learning Center of Northeast Arkansas, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Jonesboro, AR
  • NPI 1376671008
  NPD (past)

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1194482505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 FOX MEADOW LANE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049346",
            "telephone_number": "870-335-2240",
            "fax_number": "870-931-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 FOX MEADOW LANE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049346",
            "telephone_number": "870-335-2240",
            "fax_number": "870-931-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODYARD",
        "first_name": "CARLY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-19",
        "last_updated": "2024-07-24",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286660721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "MATTESON",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tommy L Woods
• Caretta Woodson-Barbee
• Marsha Woodson
• Gary W Woodward, MD
• Jared Craig Woodward
• Jeremy Michael Wooldridge, LCSW
• Michael Wooldridge, OT-A
• Taylor Ann Wooldridge, PTA
• Trey Wooldridge
• Calvin J Wooridge

• Occupational Therapist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.