Individual provider Active NPI

Morgan Reyes, COTA

  • Occupational Therapy Assistant
  • Bentonville, AR
National Provider Identifier
1326484288
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
1601 Greenhouse Rd
Bentonville, AR 72713-9292
Phone
(479) 795-1260
NPI assigned
May 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OT-A759 AR
Occupational Therapy Assistant 224Z00000X Primary

Addresses

Primary practice location

1601 Greenhouse Rd
Bentonville, AR 72713-9292

Mailing address

3801 Main Dr Ste B
Fayetteville, AR 72704-6364
Phone (479) 856-6400

Other practice location 1

3801 Main Dr Ste B
Fayetteville, AR 72704-6364
Phone (479) 856-6400

Other identifiers 1

IdentifierTypeStateIssuer
197298721MedicaidAR

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
OT-A759ARMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thera-Play Pediatric Services Past Accepting new patients
Imagine Occupational Therapy Services Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1326484288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MAIN DR STE B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046364",
            "telephone_number": "479-856-6400",
            "fax_number": "479-856-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 GREENHOUSE RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727139292",
            "telephone_number": "479-795-1260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Main Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727046364",
            "country_code": "US",
            "telephone_number": "479-856-6400",
            "fax_number": "479-856-6623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "MORGAN",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A759",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197298721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.