Karis Bradshaw

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

359 School Ave
West Fork, AR 72774-3176

Phone

(479) 839-2231

NPI assigned

Jan 29, 2024

Last updated

Feb 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1780446328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W LAFAYETTE ST APT 21",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727014129",
            "telephone_number": "901-651-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 SCHOOL AVE",
            "city": "WEST FORK",
            "state": "AR",
            "postal_code": "727743176",
            "telephone_number": "479-839-2231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "476 N Center St",
            "address_purpose": "LOCATION",
            "city": "Elkins",
            "state": "AR",
            "postal_code": "727273315",
            "country_code": "US",
            "telephone_number": "479-643-3380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 E Buchanan St",
            "address_purpose": "LOCATION",
            "city": "Prairie Grove",
            "state": "AR",
            "postal_code": "727532900",
            "country_code": "US",
            "telephone_number": "479-846-4213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "KARIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in West Fork, AR
• Providers in West Fork, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.

Verify at the official NPI Registry.