Individual provider Active NPI

Trista Lashaun Smith, COTA

  • Occupational Therapy Assistant
  • Duncanville, TX
National Provider Identifier
1407332208
Registry record updated Jul 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
210715 Issued in TX
Practice address
419 S Cockrell Hill Rd
Duncanville, TX 75116-4939
Phone
(972) 708-8801
NPI assigned
Jul 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 210715 TX Primary

Addresses

Primary practice location

419 S Cockrell Hill Rd
Duncanville, TX 75116-4939

Mailing address

1401 Judy LN
Mansfield, TX 76063-8659
Phone (318) 613-2674

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
210715TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1531612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531612800000",
    "number": "1407332208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 JUDY LN",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638659",
            "telephone_number": "318-613-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S COCKRELL HILL RD",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164939",
            "telephone_number": "972-708-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TRISTA",
        "middle_name": "LASHAUN",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-15",
        "last_updated": "2018-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "210715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncanville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2018; 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.