Active NPI
Debbie Royal, OTR L
- Pediatric Occupational Therapist
- Fayetteville, AR
National Provider Identifier
1306955489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OTR1879
- Practice address
- 48 W Colt Square Dr
Fayetteville, AR 72703-2813 - Phone
- (479) 582-2740
- Fax
- (479) 582-2746
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OTR1879 | AR | Primary |
Addresses
Primary practice location
48 W Colt Square Dr
Fayetteville, AR 72703-2813
Mailing address
1794 Madison 7750
Hindsville, AR 72738
Phone (479) 456-7116
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124040721 | Medicaid | AR |
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 |
|---|---|---|---|
| OTR1879 | AR | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cross Therapy Services, LTD | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Occupational Therapist
- Fayetteville, AR
- NPI 1407964802
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1306955489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1794 MADISON 7750",
"city": "HINDSVILLE",
"state": "AR",
"postal_code": "72738",
"telephone_number": "479-456-7116",
"fax_number": "479-582-2746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 W COLT SQUARE DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727032813",
"telephone_number": "479-582-2740",
"fax_number": "479-582-2746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROYAL",
"first_name": "DEBBIE",
"name_prefix": "Mrs.",
"credential": "OTR L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AR",
"license": "OTR1879",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "124040721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.