Individual provider Active NPI

Alyssa Oldani, OTR/L

  • Occupational Therapist
  • Bartlett, TN
National Provider Identifier
1609444546
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6874 Issued in TN
Practice address
3045 Kate Bond Rd
Bartlett, TN 38133-4004
Phone
(901) 937-3200
Fax
(901) 383-1738
NPI assigned
Jun 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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 6874 TN Primary
Occupational Therapist 225X00000X OT-3869 MS

Addresses

Primary practice location

3045 Kate Bond Rd
Bartlett, TN 38133-4004

Mailing address

3045 Kate Bond Rd
Bartlett, TN 38133-4004
Phone (901) 937-3200

Other practice location 1

5699 Getwell Rd Bldg E4
Southaven, MS 38672-7311
Phone (662) 536-4695

Other names 1

  • Alyssa Blumenberg Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Webpt Health Information Exchange (HIE) Memphis Hand Center, Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240702002233 AR Practitioner - Occupational Therapist in Private Practice 0143624726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-3869MSMDOccupational Therapist
6874TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fusion Therapy Center, LLC Occupational Therapist CurrentSince Jun 20, 2024 Accepting new patients
Memphis Hand Center, Inc PastSince Jun 1, 2021 Accepting new patients
MSK Group PC Past Accepting new patients
Memphis Hand Center PastSince Jun 1, 2021 Accepting new patients

Locations

3108 SW Regency Pkwy
Ste 5
Bentonville, AR 72712
Phone (479) 252-3321

3201 SW Regency Pkwy
Ste 5
Bentonville, AR 72712
Phone (479) 252-3321

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1609444546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 KATE BOND RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334004",
            "telephone_number": "901-937-3200",
            "fax_number": "901-383-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 KATE BOND RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334004",
            "telephone_number": "901-937-3200",
            "fax_number": "901-383-1738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5699 Getwell Rd Bldg E4",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386727311",
            "country_code": "US",
            "telephone_number": "662-536-4695",
            "fax_number": "662-536-4696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLDANI",
        "first_name": "ALYSSA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "6874",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT-3869",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Webpt",
            "affiliation": "Y",
            "endpointDescription": "electronic medical record system",
            "affiliationName": "Memphis Hand Center, Inc",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5699 Getwell Rd Bldg E4",
            "city": "Southaven",
            "state": "MS",
            "country_code": "US",
            "postal_code": "386727311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "BLUMENBERG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.