Marilyn Jennifer Smith-Haynes, COTA, CAPS

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

213831 Issued in TX

Practice address

3617 Ebenezer Rd
Marietta, GA 30066-2819

Phone

(757) 589-0864

Fax

(770) 805-0556

NPI assigned

Apr 11, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1467816835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 EBENEZER RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662819",
            "telephone_number": "757-589-0864",
            "fax_number": "770-805-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 EBENEZER RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662819",
            "telephone_number": "757-589-0864",
            "fax_number": "770-805-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-HAYNES",
        "first_name": "MARILYN",
        "middle_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "COTA, CAPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Environmental Modification",
            "state": "GA",
            "license": "OTA000977",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "213831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jennifer Smiles, PTA
• Almira M Smith, PT
• Andrew Christian Smith, DO
• Anna Ford Smith, LPC, ATR-BC
• Ashley Earldaniel Smith, DMD
• Ashley Renee Smith, AGACNP-BC, MSN, BA

• Occupational Therapy Assistant in Marietta, GA
• Providers in Marietta, GA by specialty
• Occupational Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.