Active NPI
Kristine Smoot, OTR/L
- Gerontology Occupational Therapist
- Canton, MI
National Provider Identifier
1376959361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Occupational Therapist
- License
- 5201008840
- Practice address
- 44075 Candlewood Dr
Canton, MI 48187-1903 - Phone
- (734) 788-5581
- NPI assigned
- Jul 10, 2014
- 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 |
|---|---|---|---|---|
| Gerontology Occupational Therapist | 225XG0600X | 5201008840 | MI | Primary |
Addresses
Primary practice location
44075 Candlewood Dr
Canton, MI 48187-1903
Mailing address
44075 Candlewood Dr
Canton, MI 48187-1903
Phone (734) 788-5581
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201008840 | MI | MD | Gerontology Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570665600000",
"number": "1376959361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44075 CANDLEWOOD DR",
"city": "CANTON",
"state": "MI",
"postal_code": "481871903",
"telephone_number": "734-788-5581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44075 CANDLEWOOD DR",
"city": "CANTON",
"state": "MI",
"postal_code": "481871903",
"telephone_number": "734-788-5581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMOOT",
"first_name": "KRISTINE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-10",
"last_updated": "2019-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "MI",
"license": "5201008840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.