Active NPI
Wendy Leigh Burnett, OTRL
- Occupational Therapist
- Benton, AR
National Provider Identifier
1609836980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR1435
- Practice address
- 121 Cox St
Benton, AR 72015-4611 - Phone
- (501) 351-2192
- NPI assigned
- Mar 23, 2006
- Last updated
- Jun 10, 2014
- Sex
- Female
- Sole proprietor
- No
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 | OTR1435 | AR | Primary |
Addresses
Primary practice location
121 Cox St
Benton, AR 72015-4611
Mailing address
121 Cox Street
Ste 3
Benton, AR 72015
Phone (501) 351-2192
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 137072721 | Medicaid | AR | |
| 5U879 | Other | AR | BCBS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR1435 | AR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402358400000",
"number": "1609836980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 COX STREET",
"address_2": "STE 3",
"city": "BENTON",
"state": "AR",
"postal_code": "72015",
"telephone_number": "501-351-2192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 COX ST",
"city": "BENTON",
"state": "AR",
"postal_code": "720154611",
"telephone_number": "501-351-2192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNETT",
"first_name": "WENDY",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-23",
"last_updated": "2014-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR1435",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "137072721",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5U879",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.