Active NPI
Sidney Max Brown
- Occupational Therapy Assistant
- Paragould, AR
National Provider Identifier
1821701798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OT-A1587
- Practice address
- 4849 Highway 358
Paragould, AR 72450-9619 - Phone
- (870) 476-9474
- NPI assigned
- Jan 5, 2023
- 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 Therapy Assistant | 224Z00000X | OT-A1587 | AR | Primary |
Addresses
Primary practice location
4849 Highway 358
Paragould, AR 72450-9619
Mailing address
4849 Highway 358
Paragould, AR 72450-9619
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 |
|---|---|---|---|
| OT-A1587 | AR | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672876800000",
"number": "1821701798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4849 HIGHWAY 358",
"city": "PARAGOULD",
"state": "AR",
"postal_code": "724509619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4849 HIGHWAY 358",
"city": "PARAGOULD",
"state": "AR",
"postal_code": "724509619",
"telephone_number": "870-476-9474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SIDNEY",
"middle_name": "MAX",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-05",
"last_updated": "2023-01-05",
"certification_date": "2023-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AR",
"license": "OT-A1587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paragould, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.