Individual provider Active NPI

Jodi Lee Eaton, OTRL

  • Occupational Therapist
  • Little Rock, AR
National Provider Identifier
1679603799
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR1726 Issued in AR
Practice address
3920 Woodland Heights Rd
Little Rock, AR 72212-2495
Phone
(501) 315-4414
Fax
(501) 315-3467
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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 OTR1726 AR Primary

Addresses

Primary practice location

3920 Woodland Heights Rd
Little Rock, AR 72212-2495

Mailing address

3920 Woodland Heights Rd
Little Rock, AR 72212-2495
Phone (501) 227-3622

Other identifiers 1

IdentifierTypeStateIssuer
160421721MedicaidAR

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
OTR1726ARMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224460800000",
    "number": "1679603799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 WOODLAND HEIGHTS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722122495",
            "telephone_number": "501-227-3622",
            "fax_number": "501-227-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 WOODLAND HEIGHTS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722122495",
            "telephone_number": "501-315-4414",
            "fax_number": "501-315-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "JODI",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR1726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160421721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 20, 2008; 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.