Individual provider Active NPI

Jessica Yang

  • Occupational Therapist
  • Bentonville, AR
National Provider Identifier
1619552114
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR4116 Issued in AR
Practice address
210 N Walton Blvd Ste 30U
Bentonville, AR 72712-4930
Phone
(479) 351-0713
Fax
(479) 391-5269
NPI assigned
Mar 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X OTR4116 AR Primary

Addresses

Primary practice location

210 N Walton Blvd Ste 30U
Bentonville, AR 72712-4930

Mailing address

8619 W Forest Hills Dr
Fayetteville, AR 72704-7850
Phone (417) 846-7685

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

LicenseStateTypeSpecialty
OTR4116ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meeting Milestones Pediatric Therapy LLC Multi-Specialty CurrentSince Oct 5, 2025 Accepting new patients
Regional Therapy Services, Inc. Multi-Specialty PastSince Mar 1, 2023 Accepting new patients
Regional Therapy Services, Inc. Multi-Specialty PastSince Mar 1, 2023 Accepting new patients

Organizations & group practices 3

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": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1619552114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8619 W FOREST HILLS DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727047850",
            "telephone_number": "417-846-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N WALTON BLVD STE 30U",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124930",
            "telephone_number": "479-351-0713",
            "fax_number": "479-391-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR4116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.