Garrett Polk

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR2647 Issued in AR

Practice address

1500 Wilson Loop
Ward, AR 72176-8656

Phone

(501) 941-5630

NPI assigned

Nov 11, 2013

Sex

Male

Sole proprietor

No

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.

• Allied Therapy and Consulting Services, PA

  • Specialist
  • North Little Rock, AR
  • NPI 1134185937
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 11, 2013.

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384128000000",
    "number": "1407285406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WILSON LOOP",
            "city": "WARD",
            "state": "AR",
            "postal_code": "721768656",
            "telephone_number": "501-941-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WILSON LOOP",
            "city": "WARD",
            "state": "AR",
            "postal_code": "721768656",
            "telephone_number": "501-941-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "GARRETT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-11",
        "last_updated": "2013-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR2647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199468721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Greer McCrory, CCC-SLP
• Margaret McGee
• New Roots Counseling Services, LLC
• Bethany Shea Pearrow
• Holly Peters
• Rebekah Marie Prine
• Jamye Rankin, SLP
• Raena G Rawlinson, RPT
• Amy Reynolds
• Kellie Rine

• All providers in Ward, AR
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2013; 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.