Brandi Michelle Chisholm, COTA/L, DOR

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A629 Issued in AR

Practice address

2642 N Dudney Rd
Magnolia, AR 71753-4305

Phone

(870) 234-7000

Fax

(870) 234-7168

NPI assigned

Feb 2, 2016

Last updated

Feb 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1861850067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 COLUMBIA ROAD 78",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717538733",
            "telephone_number": "870-904-7868",
            "fax_number": "870-234-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2642 N DUDNEY RD",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717534305",
            "telephone_number": "870-234-7000",
            "fax_number": "870-234-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "BRANDI",
        "middle_name": "MICHELLE",
        "credential": "COTA/L, DOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Health Therapy and Rehabiliation LLC
• James William Chambliss, M.D.
• Anna Marie Chandler, PHARM D
• Christy L. Cheatham, O.T.
• Chester Wynn MD PA
• Jamie C Cisneros, MD
• Garrett Clark
• Jo Ann Clark, APRN
• Kadie Lauren Clark, COTA/L
• Sara Clements, LCSW

• Occupational Therapy Assistant in Magnolia, AR
• Providers in Magnolia, 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 Feb 2, 2016; 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.