Active NPI
Benjie Acosta Letran, OT
- Occupational Therapist
- Bentonville, AR
National Provider Identifier
1760540140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTR1830
- Practice address
- 803 SE Plaza Ave
Bentonville, AR 72712-7772 - Phone
- (479) 636-1270
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- No
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 | OTR1830 | AR | Primary |
Addresses
Primary practice location
803 SE Plaza Ave
Bentonville, AR 72712-7772
Mailing address
1519 S.20TH St.
Rogers, AR 72758
Phone (479) 636-1270
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5Y831 | Other | AR | ABCBS |
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 |
|---|---|---|---|
| OTR1830 | AR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760540140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1519 S.20TH ST.",
"city": "ROGERS",
"state": "AR",
"postal_code": "72758",
"telephone_number": "479-636-1270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 SE PLAZA AVE",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727127772",
"telephone_number": "479-636-1270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LETRAN",
"first_name": "BENJIE",
"middle_name": "ACOSTA",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AR",
"license": "OTR1830",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ABCBS",
"identifier": "5Y831",
"state": "AR"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.