Active NPI
Brooke Aubrey Granger, COTA
- Occupational Therapy Assistant
- Holiday Island, AR
National Provider Identifier
1427574144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- Practice address
- 1 Park Dr Ste a
Holiday Island, AR 72631-9405 - Phone
- (479) 363-6422
- NPI assigned
- Aug 15, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | AR | Primary |
Addresses
Primary practice location
1 Park Dr Ste a
Holiday Island, AR 72631-9405
Mailing address
3731 Baughman Cutoff Rd
Harrison, AR 72601-7701
Phone (816) 217-0041
Other practice location 1
400 E Highway 43
Harrison, AR 72601-6514
Phone (870) 204-5305
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1427574144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3731 BAUGHMAN CUTOFF RD",
"city": "HARRISON",
"state": "AR",
"postal_code": "726017701",
"telephone_number": "816-217-0041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PARK DR STE A",
"city": "HOLIDAY ISLAND",
"state": "AR",
"postal_code": "726319405",
"telephone_number": "479-363-6422"
}
],
"practiceLocations": [
{
"address_1": "400 E Highway 43",
"address_purpose": "LOCATION",
"city": "Harrison",
"state": "AR",
"postal_code": "726016514",
"country_code": "US",
"telephone_number": "870-204-5305",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRANGER",
"first_name": "BROOKE",
"middle_name": "AUBREY",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-15",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holiday Island, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.