Brenda Rae Smith, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5512 Issued in AZ

Practice address

844 N Ellsworth Rd
Mesa, AZ 85207-5114

Phone

(480) 380-2810

Fax

(480) 380-2861

NPI assigned

Aug 15, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• JWG, Inc

  • Physical Therapist
  • Mesa, AZ
  • NPI 1467599035
  NPD (past)

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1598198301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 N ELLSWORTH RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852075114",
            "telephone_number": "480-380-2810",
            "fax_number": "480-380-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 N ELLSWORTH RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852075114",
            "telephone_number": "480-380-2810",
            "fax_number": "480-380-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRENDA",
        "middle_name": "RAE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "5512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Jean Smith, M.D.
• Anna Maria Smith, MC, LPC, LISAC
• Belinda E Smith, CNM
• Betty C Smith, CRNFA
• Bonita B Smith, N.P.-C.
• Brenden Smith, PA
• Brittney Smith, M.S. CCC-SLP
• Chaz Smith
• Cheryl A. Smith, M.S., L.P.C.
• Christopher Smith, DMD

• Occupational Therapy Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Occupational Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.