MRS. AMANDA ELIZABETH JACKSON (NPI# 1861452112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861452112 |
| Entity Type | Individual |
| Full Name | MRS. AMANDA ELIZABETH JACKSON |
| Credential | OTR L |
| Practice Address |
121 Cox St Benton AR 72015-4611 |
| Mailing Address |
121 Cox St P.o. Box 368 Benton AR 72015-4611 |
| Practice Telephone | 5017760691 |
| Practice Fax Number | 5017760692 |
| Mailing Telephone | 5017760691 |
| Mailing Fax Number | 5017760692 |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2009-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | OTR1621 | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 143678721 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669008397 | Amanda Jackson | Pharmacist | 1418a W Main St Ste A, Lebanon, TN 37087-3114 | 2020-03-13 |
| 1730692765 | Amanda Lyn Jackson | Occupational Therapist | 2222 S Rockport Rd, Boonville, IN 47601-7926 | 2017-11-13 |
| 1982143467 | Amanda Jackson | Occupational Therapist | 5305 Reserve Dr Ne, Brookhaven, GA 30319-5924 | 2017-02-17 |
| 1528309473 | Amanda Nicole Jackson | Licensed Practical Nurse | 923 Cottage Ave, Miamisburg, OH 45342-1805 | 2013-03-01 |
| 1013254887 | Amanda Meister Jackson | Pharmacist | 10358 Riverside Dr Ste 140, Palm Beach Gardens, FL 33410-4203 | 2013-01-13 |
| 1285905240 | Amanda Jackson | Occupational Therapist | 1760 Turning Leaf Trl, Haughton, LA 71037-9531 | 2012-01-23 |
| 1245368661 | Amanda L Jackson | Physical Therapist | 17 Carlton Rd, Hutchinson, KS 67502-4423 | 2007-02-28 |
| 1437763638 | Amanda Jackson | Pharmacist | 7301 Theodore Dawes Rd, Theodore, AL 36582-4029 | 2020-09-04 |
| 1205460045 | Amanda Jackson | Registered Nurse | 940 W Mount Vernon St Ste 220, Nixa, MO 65714-9613 | 2020-03-02 |
| 1629609748 | Amanda Jackson | Community Health Worker | 401 Tuscarawas St W Ste 501, Canton, OH 44702-2045 | 2020-01-28 |
| Street Address |
121 COX ST |
| City | BENTON |
| State | AR |
| Zip Code | 72015-4611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831666106 | Kendra Danielle Wooley | Occupational Therapy Assistant | 121 Cox St, Benton, AR 72015-4611 | 2018-10-25 |
| 1750678090 | Dana Louann Fiedler | Occupational Therapy Assistant | 121 Cox St, Benton, AR 72015-4611 | 2011-07-07 |
| 1588856561 | Linda Katherine Wooten | Speech-Language Pathologist | 121 Cox St, Benton, AR 72015-4611 | 2007-08-14 |
| 1992834675 | Regina S Kelley | Speech-Language Pathologist | 121 Cox St, Benton, AR 72015-4611 | 2007-03-05 |
| 1720196595 | Misty C Ray | Speech-Language Pathologist | 121 Cox St, Benton, AR 72015-4611 | 2006-08-29 |
| 1609836980 | Wendy Leigh Burnett | Occupational Therapist | 121 Cox St, Benton, AR 72015-4611 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790343135 | Justin King | Case Manager/Care Coordinator | 1502 Mary Kay Blv6, Benton, AR 72015 | 2019-05-31 |
| 1790253326 | Seth Alexander Weisheit | Nurse Practitioner | 824 Military Road, Benton, AR 72015 | 2018-11-13 |
| 1396269627 | Abby G Sims | Speech-Language Pathologist | 3391 Peachtree Lane, Benton, AR 72015 | 2017-07-28 |
| 1225551278 | Jessica R Poe | Case Manager/Care Coordinator | 1502 Marykay Blvd, Benton, AR 72015 | 2017-07-21 |
| 1003357997 | Jamaal Langston | Case Manager/Care Coordinator | 1502 Mark Kay Blvd, Benton, AR 72015 | 2017-03-13 |
| 1881138550 | Shannon Gachot-ridgley | Counselor | 205 South Street Suite 3, Benton, AR 72015 | 2016-12-14 |
| 1295104578 | Excel Health of Haskell, Pllc | Clinical Nurse Specialist | 6029 Us Hwy 67, Haskell, AR 72015 | 2015-09-17 |
| 1528464054 | Kacey Jo Kiker | Nurse Practitioner | 620 W South St, Benton, AR 72015 | 2014-11-11 |
| 1700218252 | Jamie Brunt | Licensed Practical Nurse | 1718 Old Hot Springs Rd, Benton, AR 72015 | 2013-08-07 |
| 1760738942 | Kari J Richards | Physical Therapist | 5701 Springhill Rd, Bryant, AR 72015 | 2012-07-25 |
| Find all providers in zip 72015 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and 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 therapists 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, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003341900 | Taralee Reeves | Occupational Therapist | 1306 Military Rd Ste 1, Benton, AR 72015-2732 | 2017-04-28 |
| 1093266538 | Mallory Moix | Occupational Therapist | 17706 Interstate 30 N, Suite 3, Benton, AR 72019-2907 | 2016-10-19 |
| 1881142917 | Dana Sollars | Occupational Therapist | 207 W Conway St, Benton, AR 72015-3727 | 2016-09-19 |
| 1033580923 | Danielle Kay Freeman | Occupational Therapist | 959 Crouch Rd, Benton, LA 71006-4330 | 2015-10-17 |
| 1336525831 | Effaney Crain | Occupational Therapist | 11468 State Highway 37, Benton, IL 62812-4402 | 2015-08-06 |
| 1285027490 | Dream Big Pediatric Therapies | Occupational Therapist | 3701 Kayce Ln, Benton, AR 72019-0912 | 2015-03-12 |
| 1871986976 | Mariah Stubblefield | Occupational Therapist | 14840 State Highway 14, Benton, IL 62812-4712 | 2015-03-12 |
| 1700275864 | Susan C Padgett | Occupational Therapist | 321 Mount Moriah Rd, Benton, KY 42025-6944 | 2015-01-13 |
| 1225426661 | Melinda Davis | Occupational Therapist | 2301 Indian Valley, Benton, AR 72019-8212 | 2015-01-08 |
| 1649515495 | Cassie Fleming | Occupational Therapist | 147 Corinth Rd, Benton, KY 42025-5921 | 2012-12-05 |
| Find all providers in BENTON | ||||
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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.