Active NPI
Julie Goggins Brazil, OCCUPATIONAL THERAPI
- Occupational Therapist
- Ward, AR
National Provider Identifier
1720128762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR503
- Practice address
- 1500 Wilson Loop
Ward, AR 72176 - Phone
- (501) 941-5630
- NPI assigned
- Feb 7, 2007
- Last updated
- Nov 8, 2023
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTR503 | AR | Primary |
Addresses
Primary practice location
1500 Wilson Loop
Ward, AR 72176
Mailing address
1434 Fern Creek Circle
Benton, AR 72019-9609
Phone (501) 772-6667
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5X311 | Other | AR | BLUE CROSS BLUE SHIELD |
| OTR503 | Medicaid | AR | |
| 120324721 | Medicaid | AR |
Other names 1
- Julie Goggins Sobkoviak
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 |
|---|---|---|---|
| OTR503 | AR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allied Therapy and Consulting Services, PA | Past | Accepting new patients |
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.
-
- Specialist
- North Little Rock, AR
- NPI 1134185937
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1720128762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1434 FERN CREEK CIRCLE",
"city": "BENTON",
"state": "AR",
"postal_code": "720199609",
"telephone_number": "501-772-6667",
"fax_number": "501-221-3870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 WILSON LOOP",
"city": "WARD",
"state": "AR",
"postal_code": "72176",
"telephone_number": "501-941-5630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAZIL",
"first_name": "JULIE",
"middle_name": "GOGGINS",
"name_prefix": "Ms.",
"credential": "OCCUPATIONAL THERAPI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2023-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR503",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5X311",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OTR503",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120324721",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JULIE",
"last_name": "SOBKOVIAK",
"middle_name": "GOGGINS",
"credential": "OCCUPATIONAL THERAPI",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ward, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.