Active NPI
Johanna Aileen Smith Black, OTD, OTR/L
- Occupational Therapist
- Beachwood, OH
National Provider Identifier
1356051445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 26900 Cedar Rd
Beachwood, OH 44122-1191 - Phone
- (216) 839-3777
- NPI assigned
- Nov 29, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
26900 Cedar Rd
Beachwood, OH 44122-1191
Mailing address
23351 Chagrin Blvd Apt 404
Beachwood, OH 44122-5522
Phone (419) 345-0565
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 404778 | Other | NBCOT | |
| OT-010251 | Other | OH | OHIO OTPTATC BOARD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669680000000",
"number": "1356051445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23351 CHAGRIN BLVD APT 404",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441225522",
"telephone_number": "419-345-0565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26900 CEDAR RD",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441221191",
"telephone_number": "216-839-3777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "JOHANNA",
"middle_name": "AILEEN SMITH",
"credential": "OTD, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-29",
"last_updated": "2022-11-29",
"certification_date": "2022-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NBCOT",
"identifier": "404778",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO OTPTATC BOARD",
"identifier": "OT-010251",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.