Individual provider Active NPI

Carmen Lorraine Long, OTR L

  • Occupational Therapist
  • Little Rock, AR
National Provider Identifier
1619922374
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR142 Issued in AR
Practice address
9000 N Rodney Parham Rd
Little Rock, AR 72205-1646
Phone
(501) 503-5160
Fax
(501) 503-5160
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTR142 AR Primary

Addresses

Primary practice location

9000 N Rodney Parham Rd
Little Rock, AR 72205-1646

Mailing address

9000 N Rodney Parham Rd
Little Rock, AR 72205-1646
Phone (501) 503-5160

Other identifiers 1

IdentifierTypeStateIssuer
116099721MedicaidAR

Other names 1

  • Miss Carmen Lorraine Nahlen Former name

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
OTR142ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Building Bridges Pediatric Therapy Services, P.L.L.C. CurrentSince Aug 9, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1619922374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 N RODNEY PARHAM RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051646",
            "telephone_number": "501-503-5160",
            "fax_number": "501-503-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 N RODNEY PARHAM RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051646",
            "telephone_number": "501-503-5160",
            "fax_number": "501-503-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "CARMEN",
        "middle_name": "LORRAINE",
        "name_prefix": "Mrs.",
        "credential": "OTR L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116099721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "NAHLEN",
            "middle_name": "LORRAINE",
            "prefix": "MISS",
            "credential": "OTR L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.