Kensey Alene Smith, OTA

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

315693 Issued in GA

Practice address

113 Commons Way Ste 402
Villa Rica, GA 30180-7040

Phone

(770) 459-6533

Fax

(770) 462-1260

NPI assigned

Jan 4, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Therapy Excellence

  • Speech-Language Pathologist
  • Villa Rica, GA
  • NPI 1801368378
  NPD (past)
• Therapy Excellence

  • Physical Therapist
  • Villa Rica, GA
  • NPI 1992269807

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1104333723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 CHURCH LN",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301804720",
            "telephone_number": "770-459-6533",
            "fax_number": "770-462-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 COMMONS WAY STE 402",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301807040",
            "telephone_number": "770-459-6533",
            "fax_number": "770-462-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENSEY",
        "middle_name": "ALENE",
        "credential": "OTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "315693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Sistrunk, LPC, MAC
• Stephanie Christine Sky, DNP-PMHNP-BC
• Derek Sloss, MD
• Small Town Eyecare Partners, LLC
• Andrew C Smith, DPT
• Melanie Woodall Smith, M.S., CCC-A
• Tanisha Lavette Smith
• Matthew Soberano, D.O.
• Soma Anesthesia Services LLC
• Courtney Spann

• All providers in Villa Rica, GA
• Pediatric Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.