Individual provider Active NPI

Julianne Patricia Braswell, O.T.R.

  • Pediatric Occupational Therapist
  • Johnson, AR
National Provider Identifier
1992915409
Registry record updated Jan 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OTR1338 Issued in AR
Practice address
4301 Greathouse Springs Road
Johnson, AR 72741
Phone
(479) 200-6555
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OTR1338 AR Primary

Addresses

Primary practice location

4301 Greathouse Springs Road
Johnson, AR 72741

Mailing address

5501 Willow Creek Dr
Ste 105
Springdale, AR 72762-8707
Phone (479) 575-9359

Other identifiers 1

IdentifierTypeStateIssuer
143862721MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120523000193 AR Practitioner - Occupational Therapist in Private Practice 9931362357 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTR1338ARMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathfinder, Inc. CurrentSince Nov 25, 2014 Accepting new patients
Northwest Physicians LLC CurrentSince Apr 1, 2014 Accepting new patients
Northwest Physicians LLC CurrentSince Apr 1, 2014 Accepting new patients
Pathfinder, Inc. Past Accepting new patients

Locations

2616 S Walton Blvd
Bentonville, AR 72712

905 N Redmond Rd
Jacksonville, AR 72076
Phone (501) 533-6302

2520 W Main St
Jacksonville, AR 72076

601 W Maple Ave
Ste 403
Springdale, AR 72764
Phone (479) 750-2742

5501 Willow Creek Dr
Ste 105
Springdale, AR 72762
Phone (479) 575-9359

Organizations & group practices 4

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484352000000",
    "number": "1992915409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 WILLOW CREEK DR",
            "address_2": "STE 105",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727628707",
            "telephone_number": "479-575-9359",
            "fax_number": "479-575-9415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 GREATHOUSE SPRINGS ROAD",
            "city": "JOHNSON",
            "state": "AR",
            "postal_code": "72741",
            "telephone_number": "479-200-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASWELL",
        "first_name": "JULIANNE",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "O.T.R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2017-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AR",
            "license": "OTR1338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143862721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2017; 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.

Verify at the official NPI Registry.