Active NPI
Hayley Gonzalez, COTA
- Occupational Therapy Assistant
- Fort Smith, AR
National Provider Identifier
1366149585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OT-A1887
- Practice address
- 2710 S 16TH St
Fort Smith, AR 72901-6458 - Phone
- (479) 719-3668
- NPI assigned
- Feb 8, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OT-A1887 | AR | Primary |
Addresses
Primary practice location
2710 S 16TH St
Fort Smith, AR 72901-6458
Mailing address
2710 S 16TH St
Fort Smith, AR 72901-6458
Phone (479) 719-3668
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-A1887 | AR | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adair Ya, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1366149585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2710 S 16TH ST",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729016458",
"telephone_number": "479-719-3668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 S 16TH ST",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729016458",
"telephone_number": "479-719-3668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "HAYLEY",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-08",
"last_updated": "2024-08-15",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "AR",
"license": "OT-A1887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.