Amy Melissa Graves, OTRL
Individual provider Active NPI Contractor · Little Rock, AR
NPI 1275664708 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1275664708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- OTR1609 (AR)
- Practice address
- 11517 Kanis Rd
Little Rock, AR 72211-3724 - Phone
- (501) 993-7171
- Fax
- (501) 223-8075
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR1609 | AR | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Therapy Company | Contractor | Past | Accepting new patients |
| Pediatric Therapy Services of Little Rock | Contractor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | OTR1609 | AR | Yes |
Addresses
Primary practice location
11517 Kanis Rd
Little Rock, AR 72211-3724
Mailing address
8 Winona Dr
Maumelle, AR 72113-6301
Phone (501) 658-8871
Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.