Active NPI
Malinda Moore
- Occupational Therapy Assistant
- Danville, AR
National Provider Identifier
1598538829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OT-A1718
- Practice address
- 10668 Lydia LN
Danville, AR 72833-6890 - Phone
- (479) 567-1090
- NPI assigned
- Oct 30, 2023
- Last updated
- Oct 30, 2023
- 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 Therapy Assistant | 224Z00000X | OT-A1718 | AR | Primary |
Addresses
Primary practice location
10668 Lydia LN
Danville, AR 72833-6890
Mailing address
PO Box 105
Adona, AR 72001-0105
Phone (479) 567-1090
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 |
|---|---|---|---|
| OT-A1718 | AR | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698624000000",
"number": "1598538829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 105",
"city": "ADONA",
"state": "AR",
"postal_code": "720010105",
"telephone_number": "479-567-1090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10668 LYDIA LN",
"city": "DANVILLE",
"state": "AR",
"postal_code": "728336890",
"telephone_number": "479-567-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "MALINDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-30",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AR",
"license": "OT-A1718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.