Jo Lee Erickson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR2783 Issued in AR

Practice address

1127 Highway 71 S
Mena, AR 71953-4033

Phone

(870) 584-8064

NPI assigned

Dec 29, 2014

Last updated

Jul 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Jo Lee Wilson Former name

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Delta Resilience LLC

  • Occupational Therapist
  • Mena, AR
  • NPI 1639859267
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1659769628",
    "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": [
        {
            "address_1": "400 Crestwood Cir Ste G",
            "address_purpose": "LOCATION",
            "city": "Mena",
            "state": "AR",
            "postal_code": "719535512",
            "country_code": "US",
            "telephone_number": "479-394-1161",
            "fax_number": "479-394-7667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "JO",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-29",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR2783",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "2783",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JO",
            "last_name": "WILSON",
            "middle_name": "LEE",
            "prefix": "MISS",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Dentistry
• John Henry Finck, M.D.

• 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 26, 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.