Individual provider Active NPI

Jennifer D Smith-Reed X, COTA

  • Occupational Therapy Assistant
  • Plano, TX
National Provider Identifier
1124696034
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
208203 Issued in TX
Practice address
5521 Village Creek Dr
Plano, TX 75093-4829
Phone
(469) 288-1808
NPI assigned
Jun 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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 208203 TX Primary

Addresses

Primary practice location

5521 Village Creek Dr
Plano, TX 75093-4829

Mailing address

209 Rugby LN
McKinney, TX 75072-5982
Phone (469) 288-1808

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

LicenseStateTypeSpecialty
208203TXMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation CurrentSince Jun 22, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1124696034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 RUGBY LN",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750725982",
            "telephone_number": "469-288-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 VILLAGE CREEK DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934829",
            "telephone_number": "469-288-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-REED",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "name_suffix": "X",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "208203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.