Active NPI
Phyllis Smith-Bowen, OTR/L
- Occupational Therapist
- Jackson, MS
National Provider Identifier
1427086792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT0499
- Practice address
- 1475 Mossline Dr
Jackson, MS 39211-2819 - Phone
- (601) 942-5051
- NPI assigned
- Jun 28, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | OT0499 | MS | Primary |
Addresses
Primary practice location
1475 Mossline Dr
Jackson, MS 39211-2819
Mailing address
1475 Mossline Dr
Jackson, MS 39211-2819
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06102222 | Medicaid | MS |
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 |
|---|---|---|---|
| OT0499 | MS | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427086792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1475 MOSSLINE DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392112819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1475 MOSSLINE DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392112819",
"telephone_number": "601-942-5051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH-BOWEN",
"first_name": "PHYLLIS",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MS",
"license": "OT0499",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06102222",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
- Smile Straight Orthodontics-Central Ms PLLC
- Smile Straight Orthodontics-Central Ms PLLC (Smile Straight Orthodontics)
- Smiles on Broadway Dental Care
- Kellie Smith Lane
- Edith Faye Smith Rayford, M.D.
- Amber Smith-Bush, PHARMD
- Anastasia Smith-McEwen, L.P.C.
- George T Smith-Vaniz, M.D.
- Amy Gale Smith, PNP-BC
- Amy Wallace Smith, N.P.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.