Active NPI
Melody Dawn Luttrell III, OTR/L
- Pediatric Occupational Therapist
- Pocahontas, AR
National Provider Identifier
1992265722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OTR2229
- Practice address
- 385 Harmony Rd
Pocahontas, AR 72455-7102 - Phone
- (870) 926-3142
- NPI assigned
- Mar 19, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OTR2229 | AR | Primary |
Addresses
Primary practice location
385 Harmony Rd
Pocahontas, AR 72455-7102
Mailing address
1406 Bibbs Rd
Pocahontas, AR 72455-9358
Phone (870) 926-3142
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190919000778 | AR | Practitioner - Occupational Therapist in Private Practice | 0648500561 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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": "1552953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1992265722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 BIBBS RD",
"city": "POCAHONTAS",
"state": "AR",
"postal_code": "724559358",
"telephone_number": "870-926-3142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "385 HARMONY RD",
"city": "POCAHONTAS",
"state": "AR",
"postal_code": "724557102",
"telephone_number": "870-926-3142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTTRELL",
"first_name": "MELODY",
"middle_name": "DAWN",
"name_suffix": "III",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-19",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AR",
"license": "OTR2229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pocahontas, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.