Mary Josephine Smith, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

32001082A Issued in IN

Practice address

2400 College Ave
Goshen, IN 46528-5010

Phone

(574) 533-0351

NPI assigned

Jun 6, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1013176742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 STEVENS AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465164002",
            "telephone_number": "574-333-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 COLLEGE AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465285010",
            "telephone_number": "574-533-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "JOSEPHINE",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32001082A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "32001082A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Jo Simpson, NP
• Mackenzie Slaven, PA-C
• Marie Diane Slough, PT
• Sydney Smiley, RBT
• Brandi Smith
• Michelle Smith, PHARMD
• Jon E Smucker, MD
• Levi Smucker, MD
• Mark L. Smucker, M.D.
• Hannah Snyder

• Occupational Therapy Assistant in Goshen, IN
• Providers in Goshen, IN by specialty
• Occupational Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.