Active NPI
Christine Banas Soriano
- Occupational Therapist
- Blytheville, AR
National Provider Identifier
1376651612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR 1812
- Practice address
- 4407 Amarillo St
Blytheville, AR 72315-5702 - Phone
- (870) 532-2229
- Fax
- (870) 532-8237
- NPI assigned
- Aug 28, 2006
- Last updated
- May 24, 2024
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTR 1812 | AR | Primary |
Addresses
Primary practice location
4407 Amarillo St
Blytheville, AR 72315-5702
Mailing address
27575 N Silverado Ranch Rd
Peoria, AZ 85383-8819
Phone (480) 823-9291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR 1812 | AR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services Inc | Occupational Therapist | Current | Accepting new patients |
| Legacy Healthcare Services Inc | Occupational Therapist | Current | Accepting new patients |
| Tomorrows Child Learning Center, LLC | Past | Accepting new patients | |
| Tomorrows Child Learning Center, LLC | Past | Accepting new patients |
Locations
110 Horizon Dr
#310
Raleigh, NC 27615
Organizations & group practices 4
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.
-
- Physical Therapist
- Chandler, AZ
- NPI 1336770221
Occupational Therapist
-
- Exclusive Provider Organization
- Blytheville, AR
- NPI 1275744773
-
- Exclusive Provider Organization
- Blytheville, AR
- NPI 1922112390
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716508800000",
"number": "1376651612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27575 N SILVERADO RANCH RD",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853838819",
"telephone_number": "480-823-9291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4407 AMARILLO ST",
"city": "BLYTHEVILLE",
"state": "AR",
"postal_code": "723155702",
"telephone_number": "870-532-2229",
"fax_number": "870-532-8237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORIANO",
"first_name": "CHRISTINE",
"middle_name": "BANAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-28",
"last_updated": "2024-05-24",
"certification_date": "2024-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR 1812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Blytheville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.