Individual provider Active NPI

Avery Smith, COTA/L

  • Occupational Therapy Assistant
  • Fayetteville, NC
National Provider Identifier
1003739053
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
17754 Issued in NC
Practice address
2465 Gillespie St
Fayetteville, NC 28306-3053
Phone
(910) 678-2300
NPI assigned
Aug 4, 2026
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 17754 NC Primary

Addresses

Primary practice location

2465 Gillespie St
Fayetteville, NC 28306-3053

Mailing address

129 Garner Rd Apt 3a
Spartanburg, SC 29303-3290
Phone (866) 871-8519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1785801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1003739053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 GARNER RD APT 3A",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033290",
            "telephone_number": "866-871-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 GILLESPIE ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283063053",
            "telephone_number": "910-678-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AVERY",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-04",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "17754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.