Codi C Oliver, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1488 Issued in OK

Practice address

1675 W. Jefferson
Ste a
Siloam Springs, AR 72761

Phone

(479) 524-8028

Fax

(479) 524-6151

NPI assigned

Jul 26, 2006

Last updated

Sep 7, 2007By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stinnett & Scarbrough P.a,

  dba Holly Street Physical Therapy

  • Physical Therapist
  • Siloam Springs, AR
  • NPI 1528016102
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1952324196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1379",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727611379",
            "telephone_number": "479-524-8028",
            "fax_number": "479-524-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 W. JEFFERSON",
            "address_2": "STE A",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "72761",
            "telephone_number": "479-524-8028",
            "fax_number": "479-524-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "CODI",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "1488",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR2061",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1488",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS STATE MEDICAL BO",
            "identifier": "OTR2061",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Arkansas Renal Dialysis Associates (Regional Kidney Center Siloam Springs Dialysis Clinic)
• Nwa Second Stage Transition
• Kayleigh O'Brien
• Matthew A Ogan
• Amy Brooke Oliver, LPC
• Debra June Oliver, COTA/L
• Gary J. Oliver
• Hannah Olson
• Onward Enterprises Inc
• Orthosource, Inc. (Kimlor Medical Supply)

• Occupational Therapist in Siloam Springs, AR
• Providers in Siloam Springs, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.