Julian Wade Ivy, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

301 N Sidney Ave
Russellville, AR 72801-4383

Phone

(479) 890-5494

Fax

(479) 967-0069

NPI assigned

Sep 29, 2017

Last updated

Sep 29, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506643200000",
    "number": "1225547516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346141",
            "telephone_number": "501-329-5459",
            "fax_number": "501-327-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N SIDNEY AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728014383",
            "telephone_number": "479-890-5494",
            "fax_number": "479-967-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "JULIAN",
        "middle_name": "WADE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Braden Scott Irwin
• Peggy Isaac, CNP
• Jillian A Ison
• Keith Alan Ison, MD
• Caydee Ivey
• Rebecca Iwanski, CASE MANAGER CARE CO
• Rosalyn Eloise-Nadine Jackson, LPC
• Whitney Jackson, LPC
• Jenessa Jacobsen, RECOVERY ASSISTANT
• James H. Taylor D.C.PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.