Individual provider Active NPI

Autumn Renee Safley, MS, OTR/L

  • Occupational Therapist
  • Searcy, AR
National Provider Identifier
1558696930
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR2304 Issued in AR
Practice address
1905 W Beebe Capps Expy
Searcy, AR 72143-5012
Phone
(501) 268-5001
Fax
(501) 268-5443
NPI assigned
Oct 2, 2009
Last updated
Jun 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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 OTR2304 AR Primary

Addresses

Primary practice location

1905 W Beebe Capps Expy
Searcy, AR 72143-5012

Mailing address

916 Coulter Rd
Sherwood, AR 72120-5935
Phone (501) 240-2240

Other names 1

  • Autumn Renee Tolliver Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201216002155 AR Practitioner - Occupational Therapist in Private Practice 3577975598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

905 N Redmond Rd
Jacksonville, AR 72076-3622
Phone (501) 982-0528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Pathfinder, Inc. CurrentSince Dec 2, 2020 Accepting new patients
Speech Solutions Inc Past Accepting new patients
Hands-on Therapy, Inc. PastSince Dec 15, 2024 Accepting new patients
Pathfinder, Inc. Past Accepting new patients

Locations

2520 W Main St
Jacksonville, AR 72076

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

Organizations & group practices 4

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": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1558696930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 COULTER RD",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721205935",
            "telephone_number": "501-240-2240",
            "fax_number": "501-268-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 W BEEBE CAPPS EXPY",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721435012",
            "telephone_number": "501-268-5001",
            "fax_number": "501-268-5443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFLEY",
        "first_name": "AUTUMN",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-02",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR2304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "TOLLIVER",
            "middle_name": "RENEE",
            "credential": "MS, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Searcy, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.