Individual provider Active NPI

Michael Todd Otis, OTR

  • Occupational Therapist
  • Little Rock, AR
National Provider Identifier
1811954522
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR1283 Issued in AR
Practice address
800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone
(501) 604-6900
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTR1283 AR Primary

Addresses

Primary practice location

800 Fair Park Blvd
Little Rock, AR 72204-1720

Mailing address

800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone (501) 978-2623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120202000664 AR Practitioner - Occupational Therapist in Private Practice 4789841792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthoarkansas PAGroup PAC ID 1456256031, 148 clinicians

Practice addresses (Care Compare)

3480 Landers Rd
North Little Rock, AR 72117-2541
Phone (501) 978-2623

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoarkansas, PA CurrentSince Feb 19, 2018 Accepting new patients
Orthoarkansas, PA CurrentSince Feb 19, 2018 Accepting new patients
Orthoarkansas, PA Past Accepting new patients

Locations

353 Cash Rd SW
Camden, AR 71701
Phone (870) 836-8101

6119 Midtown Ave
Ste 101
Little Rock, AR 72205
Phone (501) 404-8007

800 Fair Park Blvd
Little Rock, AR 72204
Phone (501) 404-8007

10301 Kanis Rd
Little Rock, AR 72205
Phone (501) 604-4151

3480 Landers Rd
North Little Rock, AR 72117
Phone (501) 955-5519

Interoperability endpoints

  • Direct secure messaging: michael.otis.1@1376.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1811954522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-978-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-604-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR1283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.