Individual provider Active NPI

Lindsey M Heckmann, COTA/L

  • Occupational Therapy Assistant
  • Jonesboro, AR
National Provider Identifier
1407443096
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OT-A1647 Issued in AR
Practice address
1699 Red Wolf Blvd
Jonesboro, AR 72401-5442
Phone
(870) 275-8558
NPI assigned
Dec 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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-A1647 AR Primary

Addresses

Primary practice location

1699 Red Wolf Blvd
Jonesboro, AR 72401-5442

Mailing address

5203 Kara Dr
Jonesboro, AR 72405-9780
Phone (870) 275-8558

Other practice location 1

5203 Kara Dr
Jonesboro, AR 72405-9780
Phone (870) 275-8558

Other identifiers 1

IdentifierTypeStateIssuer
228783706MedicaidAR

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-A1647ARMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Pediatric Therapies PA 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1407443096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 KARA DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724059780",
            "telephone_number": "870-275-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 RED WOLF BLVD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015442",
            "telephone_number": "870-275-8558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5203 Kara Dr",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724059780",
            "country_code": "US",
            "telephone_number": "870-275-8558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HECKMANN",
        "first_name": "LINDSEY",
        "middle_name": "M",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A1647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228783706",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.