Individual provider Active NPI

Lori Tankersley, OTR/L

  • Occupational Therapist
  • Ward, AR
National Provider Identifier
1437174646
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR1881 Issued in AR
Practice address
1500 Wilson Loop
Ward, AR 72176
Phone
(501) 588-3211
Fax
(501) 353-2599
NPI assigned
Jul 12, 2006
Last updated
Nov 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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 OTR1881 AR Primary

Addresses

Primary practice location

1500 Wilson Loop
Ward, AR 72176

Mailing address

28 Jerrell Rd
Mayflower, AR 72106-9646
Phone (501) 941-5630

Other identifiers 2

IdentifierTypeStateIssuer
5X731OtherARBLUE CROSS BLUE SHIELD
154489721MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210205000698 AR Practitioner - Occupational Therapist in Private Practice 0840604658 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTR1881ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Therapy and Consulting Services, PA CurrentSince Nov 4, 2020 Accepting new patients
Beyond Boundaries, Inc Occupational Therapist Past Accepting new patients
Arkansas Enterprises for the Developmentally Disabled, Inc. Past Accepting new patients

Locations

105 E Roosevelt Rd
Little Rock, AR 72206

5532 John F Kennedy Blvd
North Little Rock, AR 72116
Phone (501) 588-3211

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1437174646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 JERRELL RD",
            "city": "MAYFLOWER",
            "state": "AR",
            "postal_code": "721069646",
            "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": "72176",
            "telephone_number": "501-588-3211",
            "fax_number": "501-353-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANKERSLEY",
        "first_name": "LORI",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR1881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5X731",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154489721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ward, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.

Verify at the official NPI Registry.