Travis Shade Gilbert, OTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A928 Issued in AR

Practice address

3724 JFK Blvd
North Little Rock, AR 72116-8260

Phone

(501) 615-8563

NPI assigned

Apr 3, 2023

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

State licenses

Practice roles

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.

• Park Hill Pediatrics, Inc

  • Occupational Therapist
  • North Little Rock, AR
  • NPI 1720708191
  NPD

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1285339028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4928 LAKEVIEW RD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721166727",
            "telephone_number": "214-681-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 JFK BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721168260",
            "telephone_number": "501-615-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "TRAVIS",
        "middle_name": "SHADE",
        "name_prefix": "Mr.",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Gibbs
• Renee Gibbs, PH.D
• Lauren Elizabeth Gibson-Oliver, MD
• Ashley Monique Gibson
• Jennifer L Gibson
• Simrit Gill-Chauhan, MD
• Mohammad Danial Gill, MD
• Roger Dean Gillum, MD
• Lanissa Yvette Gilmore, LMSW
• Katrina Denise Ginger-Wiggins, MHPP

• Occupational Therapy Assistant in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.