Individual provider Active NPI

Melodie Penn

  • Occupational Therapist
  • Paragould, AR
National Provider Identifier
1689550501
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR3682 Issued in AR
Practice address
2200 Chateau Blvd
Paragould, AR 72450-6264
Phone
(501) 725-0379
NPI assigned
Aug 14, 2025
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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 OTR3682 AR Primary

Addresses

Primary practice location

2200 Chateau Blvd
Paragould, AR 72450-6264

Mailing address

1725 Meadowlark
Pocahontas, AR 72455-1493
Phone (870) 378-2583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251212001205 AR Practitioner - Occupational Therapist in Private Practice 2860986239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1722 N College Ave
Suite C 320
Fayetteville, AR 72703-2640

1725 Meadowlark
Pocahontas, AR 72455-1493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTR3682ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Therapy Services LLC CurrentSince Sep 3, 2025 Accepting new patients

Locations

5101 Harrisburg Rd
Jonesboro, AR 72404
Phone (870) 933-4535

Organizations & group practices 1

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": "1755129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1689550501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 MEADOWLARK",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "724551493",
            "telephone_number": "870-378-2583",
            "fax_number": "870-378-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 CHATEAU BLVD",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724506264",
            "telephone_number": "501-725-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "MELODIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.