Individual provider Active NPI

Jessica Crider, OTD, OTR/L

  • Occupational Therapist
  • Bentonville, AR
National Provider Identifier
1891551206
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTR3911 Issued in AR
Practice address
3201 SW Regency Pkwy
Bentonville, AR 72712-7469
Phone
(479) 252-3321
Fax
(479) 668-2257
NPI assigned
Feb 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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 OTR3911 AR Primary

Addresses

Primary practice location

3201 SW Regency Pkwy
Bentonville, AR 72712-7469

Mailing address

3201 SW Regency Pkwy
Bentonville, AR 72712-7469
Phone (479) 252-3321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240313002447 AR Practitioner - Occupational Therapist in Private Practice 4284070103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gross Therapy Services IncGroup PAC ID 5991072050, 45 clinicians

Practice addresses (Care Compare)

2200 SE J St
Suite 20And22
Bentonville, AR 72712-4185
Phone (870) 701-5089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTR3911ARMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gross Therapy Services, Inc. Occupational Therapist CurrentSince Sep 8, 2025 Accepting new patients

Locations

2355 N Center St
Ste 105
Fayetteville, AR 72701
Phone (870) 916-5455

Organizations & group practices 1

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": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1891551206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 SW REGENCY PKWY",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127469",
            "telephone_number": "479-252-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 SW REGENCY PKWY",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127469",
            "telephone_number": "479-252-3321",
            "fax_number": "479-668-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIDER",
        "first_name": "JESSICA",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR3911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.