Active NPI
Keagan Nicole Smith, OTR/L
- Occupational Therapist
- Saraland, AL
National Provider Identifier
1013517861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5371
- Practice address
- 424 Saraland Blvd N Ste F
Saraland, AL 36571-2153 - Phone
- (251) 455-4871
- NPI assigned
- Oct 30, 2020
- Last updated
- Oct 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 21211 | FL | |
| Occupational Therapist | 225X00000X | 5371 | AL | Primary |
Addresses
Primary practice location
424 Saraland Blvd N Ste F
Saraland, AL 36571-2153
Mailing address
8964 Rand Ave Apt 4208
Daphne, AL 36526-9157
Phone (251) 455-4871
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5371 | AL | MD | Pharmacist |
| 21211 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604016000000",
"number": "1013517861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8964 RAND AVE APT 4208",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365269157",
"telephone_number": "251-455-4871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 SARALAND BLVD N STE F",
"city": "SARALAND",
"state": "AL",
"postal_code": "365712153",
"telephone_number": "251-455-4871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KEAGAN",
"middle_name": "NICOLE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-30",
"last_updated": "2020-10-30",
"certification_date": "2020-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "21211",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "5371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saraland, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.