Active NPI
Alicia Ann Womack, OTR L
- Pediatric Occupational Therapist
- Perry, AR
National Provider Identifier
1376645812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OTR1148
- Practice address
- 1373 Highway 10 W
Perry, AR 72125-8005 - Phone
- (501) 662-4145
- NPI assigned
- Sep 4, 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 | OTR1148 | AR | Primary |
Addresses
Primary practice location
1373 Highway 10 W
Perry, AR 72125-8005
Mailing address
1373 Highway 10 W
Perry, AR 72125-8005
Phone (501) 662-4145
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5T631 | Other | AR | BLUE CROSS BLUE SHEILD # |
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 |
|---|---|---|---|
| OTR1148 | AR | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1376645812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1373 HIGHWAY 10 W",
"city": "PERRY",
"state": "AR",
"postal_code": "721258005",
"telephone_number": "501-662-4145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1373 HIGHWAY 10 W",
"city": "PERRY",
"state": "AR",
"postal_code": "721258005",
"telephone_number": "501-662-4145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMACK",
"first_name": "ALICIA",
"middle_name": "ANN",
"credential": "OTR L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AR",
"license": "OTR1148",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD #",
"identifier": "5T631",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.