Individual provider Active NPI

Kody Morris

  • Occupational Therapist
  • Greenwood, AR
National Provider Identifier
1255958872
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR2524 Issued in AR
Practice address
515 Forrest Park Way
Greenwood, AR 72936-5955
Phone
(479) 996-5078
NPI assigned
Jun 30, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTR2524 AR Primary

Addresses

Primary practice location

515 Forrest Park Way
Greenwood, AR 72936-5955

Mailing address

501 Ledanna Dr
Van Buren, AR 72956-6666
Phone (479) 222-3344

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
OTR2524ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bohannan Irgens Group LLC CurrentSince Jul 5, 2020 Accepting new patients
Greenwood Physical Therapy Center, Inc. PastSince Jul 5, 2020 Accepting new patients

Locations

515 Forrest Park Way
Greenwood, AR 72936
Phone (479) 597-8318

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1255958872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LEDANNA DR",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729566666",
            "telephone_number": "479-222-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FORREST PARK WAY",
            "city": "GREENWOOD",
            "state": "AR",
            "postal_code": "729365955",
            "telephone_number": "479-996-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "KODY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR2524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.