Active NPI
Risty Smith, OTR/L
- Occupational Therapist
- Port Saint Lucie, FL
National Provider Identifier
1528330065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT4024
- Practice address
- 779 SE Whitmore Dr
Port Saint Lucie, FL 34984-4569 - Phone
- (772) 713-5240
- NPI assigned
- Jan 30, 2012
- Sex
- Male
- 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 Therapist | 225X00000X | OT4024 | FL | Primary |
Addresses
Primary practice location
779 SE Whitmore Dr
Port Saint Lucie, FL 34984-4569
Mailing address
779 SE Whitmore Dr
Port Saint Lucie, FL 34984-4569
Phone (772) 713-5240
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 |
|---|---|---|---|
| OT4024 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327881600000",
"number": "1528330065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "779 SE WHITMORE DR",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349844569",
"telephone_number": "772-713-5240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "779 SE WHITMORE DR",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349844569",
"telephone_number": "772-713-5240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "RISTY",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-30",
"last_updated": "2012-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT4024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.