Active NPI
Brenda Smith
- Occupational Therapy Assistant
- Bettendorf, IA
National Provider Identifier
1467873901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 00343
- Practice address
- 2290 Crow Creek Rd
Bettendorf, IA 52722-2096 - Phone
- (563) 332-0892
- NPI assigned
- Dec 31, 2013
- Last updated
- Dec 31, 2013
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | 00343 | IA | Primary |
Addresses
Primary practice location
2290 Crow Creek Rd
Bettendorf, IA 52722-2096
Mailing address
2290 Crow Creek Rd
Bettendorf, IA 52722-2096
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00343 | Other | IA | STATE LISC NUMBER |
Other names 1
- Brenda L. Smith
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00343 | IA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388448000000",
"number": "1467873901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2290 CROW CREEK RD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527222096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2290 CROW CREEK RD",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527222096",
"telephone_number": "563-332-0892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "BRENDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-31",
"last_updated": "2013-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IA",
"license": "00343",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LISC NUMBER",
"identifier": "00343",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BRENDA",
"last_name": "SMITH",
"middle_name": "L.",
"credential": "COTA/L",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Bettendorf, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.