BRETT BLACK (NPI# 1851768303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851768303 |
| Entity Type | Individual |
| Full Name | BRETT BLACK |
| Credential | COTA/L |
| Practice Address |
405 Sw Barn Valley Rd Bentonville AR 72712-9378 |
| Practice Telephone | 5012302050 |
| Mailing Telephone | 5012302050 |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2015-08-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | OT-A1000 | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
405 SW BARN VALLEY RD |
| City | BENTONVILLE |
| State | AR |
| Zip Code | 72712-9378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662345 | Bentonville Ambulatory Surgery Center, LLC | Pain Medicine | 2902 We Mid-cities Dr, Bentonville, AR 72712 | 2020-09-08 |
| 1942837059 | Amy Crumpton | Counselor | 3504 Se Riveria Road, Bentonville, AR 72712 | 2020-03-26 |
| 1295361509 | Unbridled Holdings LLC | Physical Therapy Assistant | 9900 Price Coffee Rd, Bentonville, AR 72712 | 2020-03-18 |
| 1649803552 | Hanna Kathryn Baxendale | Pediatrics | 2900 Medical Pkwy, Ste #370, Bentonville, AR 72712 | 2020-02-19 |
| 1740746635 | Meredith C Hodges | Counselor | 2508 Se 2oth St, Bentonville, AR 72712 | 2019-02-15 |
| 1609352566 | Tripharma Inc | Pharmacy | 3500 Sw Regional Airport Blvd Ste 2, Bentonville, AR 72712 | 2018-07-13 |
| 1811406747 | Upspring Therapy, LLC | Counselor | 2106 Sw Walton Blvd, Suite B, Bentonville, AR 72712 | 2017-09-22 |
| 1023536836 | Charlotte Yuvonne Hoyle | Case Manager/Care Coordinator | 2005 S.e Walton Blvd., Bentonville, AR 72712 | 2017-08-31 |
| 1508399502 | Rosanna Nicole Rephan | Nurse Practitioner | 3101 14th St, Mercy Convenient Care, Bentonville, AR 72712 | 2017-04-06 |
| 1417305517 | Charlotte Lennette Stephenson | Behavioral Analyst | 2005 S.e. Walton Blvd., Bentonville, AR 72712 | 2016-05-31 |
| Find all providers in zip 72712 | ||||
| Taxonomy Code | 224Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapy Assistant |
| An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, source changed] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588276208 | Jessica Brooke Yocum | Occupational Therapy Assistant | 3902 Sw Boulder St Apt 27, Bentonville, AR 72713-8496 | 2020-08-24 |
| 1295956803 | Bethany Johnson | Occupational Therapy Assistant | 2705 Se G Street, Suite 1, Bentonville, AR 72712 | 2007-05-01 |
| 1518580190 | Mikaylin Shay Collette | Occupational Therapy Assistant | 910 Nw 7th St, Bentonville, AR 72712-4565 | 2020-05-18 |
| 1912465584 | Catherine Lynnel Rhodes | Occupational Therapy Assistant | 2201 E Central Ave Ste 9, Bentonville, AR 72712-5607 | 2019-03-03 |
| 1730647306 | Kelly Talley | Occupational Therapy Assistant | 2201 E Central Ave Ste 9, Bentonville, AR 72712-5607 | 2019-03-03 |
| 1417314352 | No Limits Pediatric Therapies | Occupational Therapy Assistant | 910 Nw 7th St, Bentonville, AR 72712-4565 | 2016-01-22 |
| 1326484288 | Morgan Reyes | Occupational Therapy Assistant | 1601 Greenhouse Rd, Bentonville, AR 72713-9292 | 2013-05-20 |
| 1700030780 | Sally Leighann O'kelley | Occupational Therapy Assistant | 1501 Se Walton Blvd Ste 109, Bentonville, AR 72712-3745 | 2008-11-04 |
| 1235266321 | Leah Elizabeth Burry | Occupational Therapy Assistant | 2705 Se G St Ste 1, Bentonville, AR 72712-3742 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841756 | Hannah Beth Johnston | Occupational Therapy Assistant | 970 County Road 753, Jonesboro, AR 72405-0232 | 2020-11-03 |
| 1801496559 | Kynlee Madison West | Occupational Therapy Assistant | 101 N Munn St, Warren, AR 71671-2951 | 2020-10-30 |
| 1023618915 | Rachel Erin Columbus | Occupational Therapy Assistant | 8823 Barber St, Sherwood, AR 72120-2981 | 2020-10-29 |
| 1114532553 | Rachael Masters | Occupational Therapy Assistant | 115 N Fulton St, Clarksville, AR 72830-3020 | 2020-09-12 |
| 1306459888 | Katlyn Elizabeth Young | Occupational Therapy Assistant | 5532 John F Kennedy Blvd, North Little Rock, AR 72116-6708 | 2020-08-25 |
| 1093326068 | Bonnie Allyson Dillon | Occupational Therapy Assistant | 419 W 3rd St, Corning, AR 72422-2754 | 2020-08-13 |
| 1548870744 | Kayla Deann Pickett | Occupational Therapy Assistant | 1447 Columbia Road 29, Magnolia, AR 71753-8947 | 2020-08-03 |
| 1861001240 | Tamarah Janeice Wilson | Occupational Therapy Assistant | 619 Parkview St, Van Buren, AR 72956-2703 | 2020-07-30 |
| 1568070985 | Tarnesa Nicole Ramnarine | Occupational Therapy Assistant | 121 Little River 248, Ogden, AR 71853-9545 | 2020-07-22 |
| 1740808591 | Raes of Sunshine Therapy Services | Occupational Therapy Assistant | 127 R G Davis Rd, Romance, AR 72136-7005 | 2020-07-08 |
| Find all providers with the same taxonomy | ||||
| City | BENTONVILLE |
| Zip Code | 72712 |
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| 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.