Active NPI
Eric Chandler Treadway, COTA
- Specialist
- Jonesboro, AR
National Provider Identifier
1306286323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OT-A767
- Practice address
- 1699 Stadium Blvd
Suite H
Jonesboro, AR 72401 - Phone
- (870) 336-0021
- NPI assigned
- Jul 5, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | OT-A767 | AR | Primary |
Addresses
Primary practice location
1699 Stadium Blvd
Suite H
Jonesboro, AR 72401
Mailing address
5928 Newcastle Drive
Jonesboro, AR 72401
Phone (870) 919-1626
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT-A767 | AR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372982400000",
"number": "1306286323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5928 NEWCASTLE DRIVE",
"city": "JONESBORO",
"state": "AR",
"postal_code": "72401",
"telephone_number": "870-919-1626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1699 STADIUM BLVD",
"address_2": "SUITE H",
"city": "JONESBORO",
"state": "AR",
"postal_code": "72401",
"telephone_number": "870-336-0021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREADWAY",
"first_name": "ERIC",
"middle_name": "CHANDLER",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-05",
"last_updated": "2013-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AR",
"license": "OT-A767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.