Kevin D. Smith, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Williamsport, IN
NPI 1194044644 · NPPES record last updated Apr 11, 2019
Key facts
- NPI
- 1194044644
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 32001563A (IN)
- Practice address
- 200 Short St
Williamsport, IN 47993-1031 - Phone
- (765) 762-6887
- Fax
- (765) 762-6885
- NPI assigned
- May 24, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32001563A | IN | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 32001563A | IN | Yes |
Addresses
Primary practice location
200 Short St
Williamsport, IN 47993-1031
Mailing address
1710 Henry St
Champaign, IL 61821-4302
Phone (217) 402-7052
Other providers in Williamsport, IN
- William Ringer
- Stuart L. Rotramel
- Sean Sharma
- Dakota Shirar
- Alexis Smith
- St. Vincent Williamsport Hospital
- St. Vincent Williamsport Hospital
- St. Vincent Williamsport Hospital
- St. Vincent Williamsport Hospital
- St. Vincent Williamsport Hospital
All providers in Williamsport, IN · Occupational Therapy Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.