Active NPI
Samuel Smith, OTR/L
- Physical Rehabilitation Occupational Therapist
- Freeport, ME
National Provider Identifier
1487124376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- OT2831
- Practice address
- 174 S Freeport Rd Ste 1a
Freeport, ME 04032-6160 - Phone
- (207) 865-5520
- NPI assigned
- Dec 4, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | OT2831 | ME | Primary |
Addresses
Primary practice location
174 S Freeport Rd Ste 1a
Freeport, ME 04032-6160
Mailing address
174 S Freeport Rd Ste 1a
Freeport, ME 04032-6160
Phone (207) 865-5520
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 |
|---|---|---|---|
| OT2831 | ME | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543881600000",
"number": "1487124376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 S FREEPORT RD STE 1A",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040326160",
"telephone_number": "207-865-5520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "174 S FREEPORT RD STE 1A",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040326160",
"telephone_number": "207-865-5520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SAMUEL",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-04",
"last_updated": "2018-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "ME",
"license": "OT2831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Freeport, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.