Active NPI
Hulet Smith Jr., O.T.
- Occupational Therapist
- Watkinsville, GA
National Provider Identifier
1609941913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT002264
- Practice address
- 1367 Sydneys Pass
Watkinsville, GA 30677-8393 - Phone
- (770) 725-9186
- Fax
- (603) 843-2144
- NPI assigned
- Nov 21, 2006
- Last updated
- Nov 30, 2010
- 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 | OT002264 | GA | Primary |
Addresses
Primary practice location
1367 Sydneys Pass
Watkinsville, GA 30677-8393
Mailing address
1367 Sydneys Pass
Watkinsville, GA 30677-8393
Phone (770) 725-9186
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 342037 | Other | GA | WELLCARE PROVIDER NUMBER |
| 000823237A | Medicaid | GA | |
| 10040248 | Other | GA | AMERIGROUP PROVIDER NUM |
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 |
|---|---|---|---|
| OT002264 | GA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Worksafe, PC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291075200000",
"number": "1609941913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1367 SYDNEYS PASS",
"city": "WATKINSVILLE",
"state": "GA",
"postal_code": "306778393",
"telephone_number": "770-725-9186",
"fax_number": "603-843-2144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1367 SYDNEYS PASS",
"city": "WATKINSVILLE",
"state": "GA",
"postal_code": "306778393",
"telephone_number": "770-725-9186",
"fax_number": "603-843-2144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "HULET",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "O.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-21",
"last_updated": "2010-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT002264",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE PROVIDER NUMBER",
"identifier": "342037",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000823237A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP PROVIDER NUM",
"identifier": "10040248",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watkinsville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.