Active NPI
Theodore Paul Borchers, OTRL
- Occupational Therapist
- Harrison, AR
National Provider Identifier
1235138041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR423
- Practice address
- 1420 Highway 62 65 N Ste a
Harrison, AR 72601-1959 - Phone
- (870) 743-4438
- Fax
- (870) 741-0736
- NPI assigned
- Jul 14, 2005
- Last updated
- Jan 8, 2010
- Sex
- Male
- 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 | OTR423 | AR | Primary |
Addresses
Primary practice location
1420 Highway 62 65 N Ste a
Harrison, AR 72601-1959
Mailing address
1420 Highway 62 65 N Ste a
Harrison, AR 72601-1959
Phone (870) 743-4438
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 142590721 | Medicaid | AR |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR423 | AR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262908800000",
"number": "1235138041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 HIGHWAY 62 65 N STE A",
"city": "HARRISON",
"state": "AR",
"postal_code": "726011959",
"telephone_number": "870-743-4438",
"fax_number": "870-741-0736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 HIGHWAY 62 65 N STE A",
"city": "HARRISON",
"state": "AR",
"postal_code": "726011959",
"telephone_number": "870-743-4438",
"fax_number": "870-741-0736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORCHERS",
"first_name": "THEODORE",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2010-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR423",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "142590721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harrison, AR
- Patricia Evelyn Blaylock
- Hannah Jane Boaz, APRN, PMHNP-BC
- Boone County Independent Living, Inc.
- Boone County Special Services
- Luana D Booth, CRNA
- Russell Borland, MHPP
- Boston Mountain Rural Health Center Inc. (Bmrhc Women's Health Center)
- Boston Mountain Rural Health Center Inc.
- Candace Michelle Boswell, LPC
- John-Keith William Boswell, PT, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.