Active NPI
Elana Marie Hillbrand
- Occupational Therapist
- West Fork, AR
National Provider Identifier
1578075735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR3069
- Practice address
- 272 School Ave
West Fork, AR 72774-3124 - Phone
- (479) 839-3349
- Fax
- (479) 839-3752
- NPI assigned
- Oct 27, 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 Therapist | 225X00000X | OTR3069 | AR | Primary |
Addresses
Primary practice location
272 School Ave
West Fork, AR 72774-3124
Mailing address
PO Drawer 2109
Russellville, AR 72811
Phone (479) 967-2322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 234074721 | Medicaid | AR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR3069 | AR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Friendship Community Care Inc. | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Russellville, AR
- NPI 1528144318
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673222400000",
"number": "1578075735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO DRAWER 2109",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "72811",
"telephone_number": "479-967-2322",
"fax_number": "479-967-2876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "272 SCHOOL AVE",
"city": "WEST FORK",
"state": "AR",
"postal_code": "727743124",
"telephone_number": "479-839-3349",
"fax_number": "479-839-3752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILLBRAND",
"first_name": "ELANA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-27",
"last_updated": "2023-01-09",
"certification_date": "2023-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR3069",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "234074721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Fork, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.