Individual provider Active NPI

Kaili Reane Smith, MOT, OTR/L

  • Feeding, Eating & Swallowing Occupational Therapist
  • Avondale, AZ
National Provider Identifier
1235998782
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Feeding, Eating & Swallowing Occupational TherapistTaxonomy code 225XF0002X
Practice address
1585 N 113TH Ave Ste 102
Avondale, AZ 85392-3938
Phone
(623) 259-9819
NPI assigned
Mar 18, 2024
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OTH-009567 AZ
Feeding, Eating & Swallowing Occupational Therapist 225XF0002X NU Primary

Addresses

Primary practice location

1585 N 113TH Ave Ste 102
Avondale, AZ 85392-3938

Mailing address

15116 N Cotton LN
Surprise, AZ 85388-9618
Phone (623) 259-9819

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
OTH-009567AZMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
T.E.a.M. 4 Kids, LLC Pediatrics CurrentSince Feb 2, 2025 Accepting new patients

Locations

15116 N Cotton Ln
Surprise, AZ 85388
Phone (623) 322-8250

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1235998782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15116 N COTTON LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853889618",
            "telephone_number": "623-259-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 N 113TH AVE STE 102",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853923938",
            "telephone_number": "623-259-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KAILI",
        "middle_name": "REANE",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "OTH-009567",
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.