NPIMap

Organization Active NPI

Northwest Arkansas Pediatric Therapy Services, Inc

  • Pediatric Physical Therapist
  • Pea Ridge, AR
National Provider Identifier
1447472865
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT1625 Issued in AR
Legal business name
NORTHWEST ARKANSAS PEDIATRIC THERAPY SERVICES, INC
Practice address
827 West Slack Street
Pea Ridge, AR 72751-3703
Phone
(479) 451-9434
Fax
(479) 488-6220
NPI assigned
May 3, 2007
Last updated
Jul 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Authorized official

Name
Mrs. Shelia D Wilkerson, MS,PTNPI 1609918911
Title
President
Phone
(479) 451-9434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT1625 AR Primary

Addresses

Primary practice location

827 West Slack Street
Pea Ridge, AR 72751-3703

Mailing address

PO Box 585
Pea Ridge, AR 72751-0585
Phone (479) 451-9434

Other identifiers 3

IdentifierTypeStateIssuer
5C140OtherARINSURANCE
142245716MedicaidAR
136029742MedicaidAR

National Provider Directory

National Provider Directory

Locations

2705 SE G St
Ste 1
Bentonville, AR 72712
Phone (479) 273-2345

827 Slack St
Pea Ridge, AR 72751
Phone (479) 451-2009

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280448000000",
    "number": "1447472865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 585",
            "city": "PEA RIDGE",
            "state": "AR",
            "postal_code": "727510585",
            "telephone_number": "479-451-9434",
            "fax_number": "479-488-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 WEST SLACK STREET",
            "city": "PEA RIDGE",
            "state": "AR",
            "postal_code": "727513703",
            "telephone_number": "479-451-9434",
            "fax_number": "479-488-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ARKANSAS PEDIATRIC THERAPY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-07-30",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-451-9434",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS,PT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AR",
            "license": "PT1625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "5C140",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142245716",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136029742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pea Ridge, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; 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.