Individual provider Active NPI

Leshawn Smith

  • Gerontology Occupational Therapist
  • Greenwood, SC
National Provider Identifier
1457737462
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
3130 Issued in SC
Practice address
104A Tanyard Avenue
Greenwood, SC 29646
Phone
(864) 321-9171
NPI assigned
Aug 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 3130 SC Primary

Addresses

Primary practice location

104A Tanyard Avenue
Greenwood, SC 29646

Mailing address

104A Tanyard Avenue
Greenwood, SC 29646
Phone (864) 321-9171

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3130SCMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1457737462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104A TANYARD AVENUE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29646",
            "telephone_number": "864-321-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104A TANYARD AVENUE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29646",
            "telephone_number": "864-321-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LESHAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "SC",
            "license": "3130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.