Active NPI
Autumn Smith
- Occupational Therapist
- Norfolk, NE
National Provider Identifier
1558816959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 901132
- Practice address
- 1900 Vicki LN
Norfolk, NE 68701-4558 - Phone
- (402) 372-2303
- NPI assigned
- Aug 16, 2016
- 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 Therapist | 225X00000X | 901132 | NE | Primary |
Addresses
Primary practice location
1900 Vicki LN
Norfolk, NE 68701-4558
Mailing address
1900 Vicki LN
Norfolk, NE 68701-4558
Phone (402) 372-2303
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100254262-00 | Medicaid | NE |
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 |
|---|---|---|---|
| 901132 | NE | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471305600000",
"number": "1558816959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 VICKI LN",
"city": "NORFOLK",
"state": "NE",
"postal_code": "687014558",
"telephone_number": "402-372-2303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 VICKI LN",
"city": "NORFOLK",
"state": "NE",
"postal_code": "687014558",
"telephone_number": "402-372-2303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "AUTUMN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-16",
"last_updated": "2016-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "901132",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100254262-00",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norfolk, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.