Individual provider Active NPI

Hannah Moore Rosenbaum

  • Occupational Therapist
  • Little Rock, AR
National Provider Identifier
1417468810
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR3052 Issued in AR
Practice address
10618 Breckenridge Dr
Little Rock, AR 72211-1802
Phone
(501) 217-8600
Fax
(501) 217-8636
NPI assigned
Oct 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTR3052 AR Primary

Addresses

Primary practice location

10618 Breckenridge Dr
Little Rock, AR 72211-1802

Mailing address

10618 Breckenridge Dr
Little Rock, AR 72211-1802
Phone (501) 217-8600

Other names 1

  • Hannah Lynne Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260216000688 AR Practitioner - Occupational Therapist in Private Practice 8123508512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Group IncGroup PAC ID 8325402613, 4 clinicians

Practice addresses (Care Compare)

10618 Breckenridge Dr
Little Rock, AR 72211-1802
Phone (501) 217-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTR3052ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MCT, Inc. Occupational Therapist CurrentSince Jan 11, 2026 Accepting new patients

Locations

10618 Breckenridge Dr
Little Rock, AR 72211
Phone (501) 217-8600

1500 N Mississippi St
Little Rock, AR 72207
Phone (501) 217-8600

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": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1417468810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10618 BRECKENRIDGE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111802",
            "telephone_number": "501-217-8600",
            "fax_number": "501-217-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10618 BRECKENRIDGE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111802",
            "telephone_number": "501-217-8600",
            "fax_number": "501-217-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "HANNAH",
        "middle_name": "MOORE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "MOORE",
            "middle_name": "LYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.