Beau Bordelon

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1122 S 2ND St
Cabot, AR 72023-3347

Phone

(501) 274-4422

NPI assigned

Jul 7, 2025

Sex

Male

Sole proprietor

No

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.

• Pediatrics Plus Therapy Services, LLC

  • Developmental Disabilities Clinic/Center
  • Conway, AR
  • NPI 1134277320
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 7, 2025.

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1265322762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SWN DR STE 101",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720322558",
            "telephone_number": "501-328-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 S 2ND ST",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720233347",
            "telephone_number": "501-274-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDELON",
        "first_name": "BEAU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blair Therapy Services, Inc
• Christie Blair
• Ruth Ann Blair, MD
• Anna Bohnett
• Erica D Bookout
• Kailee Bowers, QBHP
• Andrew Edward Bradberry, DO
• Jennifer Bradley
• Markeia Bradley, MHPP
• James Bart Brady, O.D.

• All providers in Cabot, AR
• Behavior Technician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.