Individual provider Active NPI

Jessica Smith, OTR/L

  • Occupational Therapist
  • Saint Cloud, FL
National Provider Identifier
1417129669
Registry record updated Jun 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
19288 Issued in FL
Practice address
7410 Crabgrass Rd
Saint Cloud, FL 34773-9220
Phone
(321) 505-4265
NPI assigned
Mar 27, 2008
Last updated
Jun 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5654 FL
Occupational Therapist 225X00000X 19288 FL Primary

Addresses

Primary practice location

7410 Crabgrass Rd
Saint Cloud, FL 34773-9220

Mailing address

7410 Crabgrass Rd
Saint Cloud, FL 34773-9220
Phone (321) 505-4265

Other practice location 1

1485 International Pkwy
Heathrow, FL 32746-5303
Phone (800) 798-6035

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240403003355 FL Practitioner - Occupational Therapist in Private Practice 3173961521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab OT FL LLCGroup PAC ID 7810395696, 55 clinicians

Practice addresses (Care Compare)

Sarasota, FL 34238
Phone (877) 407-3422

2430 County Rd 210 W B
Rehab in Motion Blake at St.
St Johns, FL 32259-2451
Phone (904) 717-7782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19288FLMDMusic Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab OT FL LLC Occupational Therapist CurrentSince Mar 1, 2024 Accepting new patients

Locations

3882 Central Sarasota Pkwy
Sarasota, FL 34238
Phone (941) 282-7965

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 2

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": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718496000000",
    "number": "1417129669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 CRABGRASS RD",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347739220",
            "telephone_number": "321-505-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 CRABGRASS RD",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347739220",
            "telephone_number": "321-505-4265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1485 International Pkwy",
            "address_purpose": "LOCATION",
            "city": "Heathrow",
            "state": "FL",
            "postal_code": "327465303",
            "country_code": "US",
            "telephone_number": "800-798-6035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2024-06-16",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "5654",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "19288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.