Marybelle Beaulieu

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A1742 Issued in AR

Practice address

3625 W Chestnut St
Rogers, AR 72756-0351

Phone

(479) 246-0101

NPI assigned

Jul 29, 2021

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

State licenses

Practice roles

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.

• Gates Therapy Group, Inc.

  • Physical Therapy Clinic/Center
  • Rogers, AR
  • NPI 1720419930
  NPD (past)

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1841963402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 S DUNN AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727016421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 W CHESTNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727560351",
            "telephone_number": "479-246-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "MARYBELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A1742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bassett Speech Pathology LLC
• Shannon R. Bassett
• Debra Kay Bauer, LCSW
• Karrie Beam, APRN
• Asher Kohl Beard, APRN-CNP
• Beaver Lake Fire Dept
• Beavers Eye Care, Inc.
• Justin Ryan Beavers, O.D.
• Kathy Beavers
• Terrell Beavers, P.D.

• Occupational Therapy Assistant in Rogers, AR
• Providers in Rogers, AR by specialty
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.