Active NPI
Tasha Kenae Smith, OTR/L
- Occupational Therapist
- Mascoutah, IL
National Provider Identifier
1083861256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056.006822
- Practice address
- 201 S 10TH St
Mascoutah, IL 62258-1736 - Phone
- (618) 566-8000
- Fax
- (618) 566-7408
- NPI assigned
- Aug 19, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.006822 | IL | Primary |
Addresses
Primary practice location
201 S 10TH St
Mascoutah, IL 62258-1736
Mailing address
201 S 10TH St
Mascoutah, IL 62258-1736
Phone (618) 566-8000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.006822 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219104000000",
"number": "1083861256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 S 10TH ST",
"city": "MASCOUTAH",
"state": "IL",
"postal_code": "622581736",
"telephone_number": "618-566-8000",
"fax_number": "618-566-7408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 S 10TH ST",
"city": "MASCOUTAH",
"state": "IL",
"postal_code": "622581736",
"telephone_number": "618-566-8000",
"fax_number": "618-566-7408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "TASHA",
"middle_name": "KENAE",
"name_prefix": "Miss",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-19",
"last_updated": "2008-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.006822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mascoutah, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.