Active NPI
Josh Blocker
- Occupational Therapist
- Russellville, AR
National Provider Identifier
1659496941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR1713
- Practice address
- 1301 Russell Rd
Russellville, AR 72801 - Phone
- (479) 967-2322
- Fax
- (479) 967-2876
- NPI assigned
- Mar 19, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | OTR1713 | AR | Primary |
Addresses
Primary practice location
1301 Russell Rd
Russellville, AR 72801
Mailing address
PO Drawer 2109
Russellville, AR 72811
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220526000586 | AR | Practitioner - Occupational Therapist in Private Practice | 6002294451 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR1713 | AR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659496941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO DRAWER 2109",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "72811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 RUSSELL RD",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "72801",
"telephone_number": "479-967-2322",
"fax_number": "479-967-2876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOCKER",
"first_name": "JOSH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR1713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Russellville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.