Active NPI
Karen Grace
- Pediatric Occupational Therapist
- Bentonville, AR
National Provider Identifier
1700648011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OTR3805
- Practice address
- 13020 Frontage Rd Ste 105
Bentonville, AR 72712-5625 - Phone
- (479) 310-9107
- NPI assigned
- Jan 23, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OTR3805 | AR | Primary |
Addresses
Primary practice location
13020 Frontage Rd Ste 105
Bentonville, AR 72712-5625
Mailing address
65 Taylor Dr
Bella Vista, AR 72714-3242
Phone (626) 224-5270
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTR3805 | AR | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1700648011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 TAYLOR DR",
"city": "BELLA VISTA",
"state": "AR",
"postal_code": "727143242",
"telephone_number": "626-224-5270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13020 FRONTAGE RD STE 105",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727125625",
"telephone_number": "479-310-9107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "KAREN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-23",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AR",
"license": "OTR3805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.