Lisa P Smith, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT002789 Issued in GA

Practice address

210 East Derenne Ave
Savannah, GA 31405

Phone

(912) 644-5300

Fax

(912) 644-5260

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optim Orthopedics, LLC

  dba Optim Orthopedics

  • Orthopaedic Surgery Physician
  • Midway, GA
  • NPI 1821639758
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1447323670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 EAST DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 EAST DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "P",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT002789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISC NUMBER",
            "identifier": "PT002789",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Smith
• Kimberly Noel Smith, EDD, BCBA
• Kristina Marie Smith, APN-BC
• Kyler Thomas Smith
• Lisa C Smith, PHARMD
• Lori Smith
• Manette Smith
• Morgan Boaen Smith
• Regina Smith, MA
• Sandra Smith

• Occupational Therapist in Savannah, GA
• Providers in Savannah, GA by specialty
• Occupational Therapist in Georgia

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

Verify at the official NPI Registry.