Individual provider Active NPI

Caitlyn J Brazil, OTD, OTR/L

  • Occupational Therapist
  • Russellville, AR
National Provider Identifier
1891433710
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
210 N Jonesboro Ave Apt B
Russellville, AR 72801-3538
Phone
(479) 970-9055
NPI assigned
May 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-22-215218 AR
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X AR Primary

Addresses

Primary practice location

210 N Jonesboro Ave Apt B
Russellville, AR 72801-3538

Mailing address

210 N Jonesboro Ave Apt B
Russellville, AR 72801-3538
Phone (479) 970-9055

Other practice location 1

415 S 6th St
Dardanelle, AR 72834-3928
Phone (479) 477-3117

Other practice location 2

719 Detroit Ave
Danville, AR 72833-9607
Phone (479) 495-2241

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

LicenseStateTypeSpecialty
RBT-22-215218ARMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1891433710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N JONESBORO AVE APT B",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013538",
            "telephone_number": "479-970-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N JONESBORO AVE APT B",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013538",
            "telephone_number": "479-970-9055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Dardanelle",
            "state": "AR",
            "postal_code": "728343928",
            "country_code": "US",
            "telephone_number": "479-477-3117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "719 Detroit Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "AR",
            "postal_code": "728339607",
            "country_code": "US",
            "telephone_number": "479-495-2241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAZIL",
        "first_name": "CAITLYN",
        "middle_name": "J",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-20",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AR",
            "license": "RBT-22-215218",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.