Individual provider Active NPI

Terra Pieper Ippolito, OTR

  • Pediatric Occupational Therapist
  • Springdale, AR
National Provider Identifier
1548622871
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
105 S Blair St
Springdale, AR 72764-4410
Phone
(479) 259-2339
NPI assigned
Mar 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Pediatric Occupational Therapist 225XP0200X Primary

Addresses

Primary practice location

105 S Blair St
Springdale, AR 72764-4410

Mailing address

105 S Blair St
Springdale, AR 72764-4410
Phone (479) 259-2339

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200522000048 AR Practitioner - Occupational Therapist in Private Practice 3779904099 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pathfinder, Inc. CurrentSince Apr 30, 2020 Accepting new patients
Pathfinder, Inc. Past Accepting new patients
Kids Spot LLC Past Accepting new patients

Locations

1004 SE 5th St
Bentonville, AR 72712
Phone (479) 254-6717

905 N Redmond Rd
Jacksonville, AR 72076
Phone (501) 533-6302

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1548622871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S BLAIR ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644410",
            "telephone_number": "479-259-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S BLAIR ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644410",
            "telephone_number": "479-259-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPPOLITO",
        "first_name": "TERRA",
        "middle_name": "PIEPER",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.