Jacqueline Smith, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

04457 Issued in MD

Practice address

120 Hospital Rd
Suite 100
Prince Frederick, MD 20678-4022

Phone

(410) 414-4846

Fax

(410) 414-4810

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1265500300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16580 WATERSIDE PL",
            "city": "HUGHESVILLE",
            "state": "MD",
            "postal_code": "206372823",
            "telephone_number": "301-274-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HOSPITAL RD",
            "address_2": "SUITE 100",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784022",
            "telephone_number": "410-414-4846",
            "fax_number": "410-414-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELINE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "04457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MECICARE PROVIDER ID",
            "identifier": "606MH211",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "770428300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurel Skiendzielewski, MS
• Michael A. Skolnick, M.D.
• Patricia A Smawley, FNP
• Lori L. Smith-Williamson, MSN, N.P.
• Chad William Smith, D.O.
• Jinaki Tamu Smith, O.D.
• Myrka Marly Smith, MD
• Shannon Smith, OTR/L
• Syreeta Smith, RBT
• Soffer Foot and Ankle Care, LLC

• Occupational Therapist in Prince Frederick, MD
• Providers in Prince Frederick, MD by specialty
• Occupational Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.

Verify at the official NPI Registry.