CREATIVE PEDIATRIC OCCUPATIONAL THERAPY, INC (NPI# 1932172608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932172608 |
| Entity Type | Organization |
| Organization Name | CREATIVE PEDIATRIC OCCUPATIONAL THERAPY, INC |
| Practice Address |
2474 E Joyce Blvd Suite 3 Fayetteville AR 72703-4519 |
| Mailing Address |
Po Box 778 Elkins AR 72727-0778 |
| Practice Telephone | 4794095067 |
| Practice Fax Number | 4795215439 |
| Mailing Telephone | 4794095067 |
| Mailing Fax Number | 4795215439 |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. ELLEN KAY BRUCE (PRESIDENT) |
| Authorized Official Telephone | 4794095067 |
| Authorized Official Credential | OTR/L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
OTR582 | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BCBS GROUP NUMBER | 5C353 | 01 |
| Street Address |
2474 E JOYCE BLVD SUITE 3 |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-4519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942676010 | Kelsie Wideman | Physical Therapist | 2474 E Joyce Blvd, Ste 2, Fayetteville, AR 72703-4519 | 2015-08-12 |
| 1043552284 | Sarah Pomietlo | Speech-Language Pathologist | 2474 E Joyce Blvd, Ste. 2, Fayetteville, AR 72703-4519 | 2013-03-26 |
| 1821341017 | Lauren Sophia Wentz | Speech-Language Pathologist | 2474 E Joyce Blvd, Ste. 2, Fayetteville, AR 72703-4519 | 2012-10-25 |
| 1154679736 | Douglas Wade Cunningham | Physical Therapy Assistant | 2474 E Joyce Blvd, Ste. 2, Fayetteville, AR 72703-4519 | 2012-08-29 |
| 1871840488 | Jennifer D Capps | Developmental Therapist | 2474 E Joyce Blvd, Ste. 2, Fayetteville, AR 72703-4519 | 2012-08-14 |
| 1295013332 | Carolyn Harlan | Developmental Therapist | 2474 E Joyce Blvd, Suite 2, Fayetteville, AR 72703-4519 | 2011-07-22 |
| 1922395342 | Jaime Paige Warrington | Physical Therapist | 2474 E Joyce Blvd, Ste. 2, Fayetteville, AR 72703-4519 | 2011-07-06 |
| 1407153935 | Kimberly Nottenkamper | Speech-Language Pathologist | 2474 E Joyce Blvd, Ste. 2, Fayetteville, AR 72703-4519 | 2011-02-18 |
| 1093023962 | Holly R Hill | Physical Therapist | 2474 E Joyce Blvd, Ste. 2, Fayetteville, AR 72703-4519 | 2010-09-14 |
| 1750521506 | Danielle N Cunningham | Physical Therapist | 2474 E Joyce Blvd, Ste. 2, Fayetteville, AR 72703-4519 | 2009-03-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| Taxonomy Code | 225XP0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| Specialization | Pediatrics |
| Occupational therapists provide services to infants, toddlers and children who have or who are at risk for developmental delays or disabilities. Occupational therapy is concerned with a child's ability to participate in daily life activities or "occupations." Occupational therapists use their unique expertise to help children with social-emotional, physical, cognitive, communication, and adaptive behavioral challenges and to help children to be prepared for and perform important learning and school-related activities and to fulfill their rule as students. Through an understanding of the impact of disability, illness, and impairment on a child's development, plan, ability to learn new skills, and overall occupational performance, occupational therapists design interventions that promote healthy development, establish needed skills, and/or modify environments, all in support of participation in daily activities. |
Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: new] Additional Resources: The American Occupational Therapy Association (AOTA) does offer voluntary board certification for a Pediatric Occupational Therapist if the applicant meets the following requirements:
|
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215308523 | Juliane Jones | Occupational Therapist | 2540 Mcarthur Landing Cir Apt 304, Fayetteville, NC 28311-9033 | 2015-10-13 |
| 1003165473 | Ashleigh Danielle Shinkle | Occupational Therapist | 1211 Ireland Dr, #a, Fayetteville, NC 28304-4321 | 2012-08-31 |
| 1124332267 | Justin Gabriel Porta | Occupational Therapist | 538 N Monroe Station Dr, Fayetteville, AR 72704-7038 | 2010-07-30 |
| 1194967026 | Kristina Bouley | Occupational Therapist | 1289 Oliver St # Sr, Fayetteville, NC 28304-4450 | 2009-03-24 |
| 1184861601 | Rania Trulley | Occupational Therapist | 2122 W Loren Cir, Fayetteville, AR 72701-3038 | 2009-01-21 |
| 1578713962 | Lynn Ann Tierney | Occupational Therapist | 46 W Colt Square Dr, Fayetteville, AR 72703-2813 | 2008-09-23 |
| 1922142272 | Mending Wings Developmental Services, Inc. | Occupational Therapist | 4066 N Cambray Dr, Fayetteville, AR 72703-5049 | 2007-02-19 |
| 1225149768 | Melinda E Lunn | Occupational Therapist | 237 E Milsap Rd, Suite 7, Fayetteville, AR 72703-6288 | 2006-08-31 |
| 1639280217 | Ashley H Miller | Occupational Therapist | 3747 W Mahogany Dr, Fayetteville, AR 72704-7079 | 2006-08-31 |
| 1336258573 | Libby S Gibson | Occupational Therapist | 237 E Milsap Dr, Suite 7, Fayetteville, AR 72703-6288 | 2006-08-30 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
Please comment or provide details below to improve the information on CREATIVE PEDIATRIC OCCUPATIONAL THERAPY, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.