Delta Resilience LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

DELTA RESILIENCE LLC

Practice address

1127 Highway 71 S
Mena, AR 71953-4033

Phone

(870) 584-8064

NPI assigned

Jul 19, 2023

Last updated

Jul 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jo Lee Erickson, OTR/LNPI 1659769628

Title

Sole Member Owner

Phone

(870) 584-8064

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jo Lee Erickson, OTR/L

  • Occupational Therapist
  • Mena, AR
  • NPI 1659769628
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1639859267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 PORT ARTHUR AVE",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719533138",
            "telephone_number": "870-584-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 HIGHWAY 71 S",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534033",
            "telephone_number": "870-584-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA RESILIENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JO",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "SOLE MEMBER OWNER",
        "authorized_official_telephone_number": "870-584-8064",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Mena, AR
• Providers in Mena, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.