Individual provider Active NPI

Pamela Lewis Kipkulei, OTD, OTR/L

  • Occupational Therapist
  • Forrest City, AR
National Provider Identifier
1285653436
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
721 Issued in AR
Practice address
3998 Highway 1 N
Forrest City, AR 72335-7637
Phone
(870) 633-1737
NPI assigned
Jul 19, 2006
Last updated
Jun 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 721 AR Primary
Pediatric Occupational Therapist 225XP0200X OTR721 AR

Addresses

Primary practice location

3998 Highway 1 N
Forrest City, AR 72335-7637

Mailing address

386 Colonial Dr
Marion, AR 72364-2335
Phone (901) 355-1117

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
721ARMDOrthodontics and Dentofacial Orthopedic Dentist
OTR721ARMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1285653436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 COLONIAL DR",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642335",
            "telephone_number": "901-355-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 HIGHWAY 1 N",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723357637",
            "telephone_number": "870-633-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPKULEI",
        "first_name": "PAMELA",
        "middle_name": "LEWIS",
        "name_prefix": "Mrs.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "721",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AR",
            "license": "OTR721",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forrest City, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.