Shannon Lynn Smith, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT00002086 Issued in WA

Practice address

400 S 43Rd St
Renton, WA 98055-5714

Phone

(425) 690-3650

NPI assigned

Jun 2, 2009

Reactivated

Feb 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Highline Physical Therapy Group

  • Physical Therapist
  • Burien, WA
  • NPI 1477797991

  Occupational Therapist

  Medicare reassignment NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Highline Physical Therapy Group

  • Physical Therapist
  • Bonney Lake, WA
  • NPI 1255147336

  Occupational Therapist

  NPD
• Multicare Health System

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1396297487
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1578799722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 100 ATTN CREDENTIALING",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574970",
            "telephone_number": "425-690-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-690-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANNON",
        "middle_name": "LYNN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "deactivation_date": "2018-12-18",
        "reactivation_date": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WA",
            "license": "OT00002086",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00002086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR AND INDUSTRIES",
            "identifier": "0291600",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578799722",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kylie Ann Smith, D.O.
• Leiana Smith, RN
• Mark Allen Smith, LMHC
• Nicole M Smith, LMP
• Sarah Mikayla Smith, OTD, OTR/L
• Wendy L Smith, LCSW
• Brandon James Snailer, MD
• Rustine Roquel Snow, MA, RC
• Kin Cheong So, D.D.S.
• Lierra Sobolevskiy, AUD

• Occupational Therapist in Renton, WA
• Providers in Renton, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.