Individual provider Active NPI

Julea Smalenberg

  • Occupational Therapist
  • Yuma, AZ
National Provider Identifier
1336574805
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
314029 Issued in AZ
Practice address
11522 E 26TH LN
Yuma, AZ 85367-4938
Phone
(928) 246-5965
NPI assigned
Sep 3, 2013
Last updated
Jun 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 314029 AZ Primary

Addresses

Primary practice location

11522 E 26TH LN
Yuma, AZ 85367-4938

Mailing address

11522 E 26TH LN
Yuma, AZ 85367-4938
Phone (928) 246-5965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191203002837 AZ Practitioner - Occupational Therapist in Private Practice 5294168399 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
314029AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay4Kidz, LLC Occupational Therapist CurrentSince Oct 15, 2019 Accepting new patients

Locations

530 E McDowell Rd
Ste 107495
Phoenix, AZ 85004

9525 E Doubletree Ranch Rd
Ste 101
Scottsdale, AZ 85258
Phone (480) 488-3946

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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1336574805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11522 E 26TH LN",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853674938",
            "telephone_number": "928-246-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11522 E 26TH LN",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853674938",
            "telephone_number": "928-246-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALENBERG",
        "first_name": "JULEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "314029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.