Isabella Ruby Smith, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057004851 Issued in IL

Practice address

4112 Fieldstone Rd
Suite B
Champaign, IL 61822

Phone

(888) 308-3728

NPI assigned

Jul 18, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Isabella Ruby Milhauser Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1447803507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 GIANT CITY RD",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618568189",
            "telephone_number": "217-454-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 FIELDSTONE RD",
            "address_2": "SUITE B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61822",
            "telephone_number": "888-308-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ISABELLA",
        "middle_name": "RUBY",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057004851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ISABELLA",
            "last_name": "MILHAUSER",
            "middle_name": "RUBY",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brenda Kay Smith, RN
• Colin Smith, B.A.
• Dionne Vanessa Smith, M.D.
• Doug C Smith
• Gabrielle Smith
• Jaimee Leeann Smith
• James Ralph Smith, PH.D.
• Jeremy A Smith, LSW
• Keyera J Smith
• Leeanne Smith

• Occupational Therapy Assistant in Champaign, IL
• Providers in Champaign, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.