Organization Active NPI

Smoky Mountain Occupational Therapy LLC

  • Occupational Therapist
  • Maryville, TN
National Provider Identifier
1407473259
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
SMOKY MOUNTAIN OCCUPATIONAL THERAPY LLC
Practice address
200 E Broadway Ave Ste 150
Maryville, TN 37804-5761
Phone
(865) 201-0213
Fax
(865) 500-3730
NPI assigned
Jun 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Jamie T Williams, OTD OTRL
Title
Member Manager
Phone
(865) 201-0213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

200 E Broadway Ave Ste 150
Maryville, TN 37804-5761

Mailing address

200 E Broadway Ave Ste 150
Maryville, TN 37804-5761
Phone (865) 201-0213

National Provider Directory

National Provider Directory

Locations

200 E Broadway Ave
Ste 150
Maryville, TN 37804
Phone (865) 201-0213

200 E Broadway Ave
Ste 200
Maryville, TN 37804
Phone (865) 238-5358

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1407473259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E BROADWAY AVE STE 150",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045761",
            "telephone_number": "865-201-0213",
            "fax_number": "865-500-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E BROADWAY AVE STE 150",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045761",
            "telephone_number": "865-201-0213",
            "fax_number": "865-500-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMOKY MOUNTAIN OCCUPATIONAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-27",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "865-201-0213",
        "authorized_official_credential": "OTD OTRL"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.