Casondra Smith
Individual provider Active NPI Occupational Therapist · Rudy, AR
NPI 1740212380 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1740212380
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OTR2010 (AR)
- Practice address
- 3918 Pecan Grove Rd
Rudy, AR 72952-9026 - Phone
- (479) 632-6337
- Fax
- (479) 632-5916
- NPI assigned
- Jul 6, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR2010 | AR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hand Rehabillitation of W. Arkansas, Inc. | Past | Accepting new patients | |
| Hand Rehabilitation of W. Ark., Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTR2010 | AR | Yes |
Addresses
Primary practice location
3918 Pecan Grove Rd
Rudy, AR 72952-9026
Mailing address
945 E Main St
Booneville, AR 72927-3843
Phone (479) 632-6337
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5Y749 | Other | AR | BLUE CROSS BS PROV # |
Other providers in Rudy, AR
- Leyna Morgan
- Nick Keeter
- Park Ivy Consultants, Inc
- Kala D Price
- Sherry Sartin
- Janessa Dionne Steely
- Stephen Storm
- Strong Roots Therapeutic Services, LLC
- Justin Suggs
- The Pediatric Promise Center LLC
All providers in Rudy, AR · Occupational Therapist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.