Individual provider Active NPI

Jessica Candelaria

  • Occupational Therapist
  • Fort Smith, AR
National Provider Identifier
1679272348
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR3760 Issued in AR
Practice address
5400 Euper LN
Fort Smith, AR 72903-3232
Phone
(479) 755-6601
NPI assigned
Mar 1, 2023
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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 OTR3760 AR Primary

Addresses

Primary practice location

5400 Euper LN
Fort Smith, AR 72903-3232

Mailing address

3127 Southwest Dr
Jonesboro, AR 72404-8404
Phone (870) 336-8100

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
OTR3760ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Unlimited Learning Academy of Fort Smith CurrentSince Mar 5, 2023 Accepting new patients
Miracle Kids Success Academy Central CurrentSince Feb 23, 2025 Accepting new patients
Kids Unlimited Learning Academy of Ft. Smith PastSince Mar 5, 2023 Accepting new patients

Locations

5400 Euper Ln
Fort Smith, AR 72903
Phone (479) 300-6400

3127 Southwest Dr
Jonesboro, AR 72404

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1679272348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3127 SOUTHWEST DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048404",
            "telephone_number": "870-336-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 EUPER LN",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729033232",
            "telephone_number": "479-755-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDELARIA",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.