Individual provider Active NPI

Bissett Krawczyk, COTA/L

  • Occupational Therapy Assistant
  • Berryville, AR
National Provider Identifier
1346022316
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OT-A1973 Issued in AR
Practice address
1004 S Main St
Berryville, AR 72616-4330
Phone
(870) 715-5359
NPI assigned
Oct 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OT-A1973 AR Primary

Addresses

Primary practice location

1004 S Main St
Berryville, AR 72616-4330

Mailing address

1004 S Main St
Berryville, AR 72616-4330
Phone (870) 715-5359

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-A1973ARMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Services of Northwest Arkansas, LLC Occupational Therapy Assistant CurrentSince Oct 22, 2023 Accepting new patients

Locations

1004 S Main St
Berryville, AR 72616
Phone (870) 423-1077

916 Goblin Dr
Harrison, AR 72601
Phone (870) 204-5330

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.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1346022316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 S MAIN ST",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164330",
            "telephone_number": "870-715-5359",
            "fax_number": "870-505-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 S MAIN ST",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164330",
            "telephone_number": "870-715-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAWCZYK",
        "first_name": "BISSETT",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A1973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berryville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.