Active NPI
Kathleen Ann Smith
- Occupational Therapist
- Fairfield, CA
National Provider Identifier
1629489802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3342
- Practice address
- 1101 B Gale Wilson Blvd
Fairfield, CA 94533-3700 - Phone
- (707) 646-4150
- NPI assigned
- May 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 3342 | CA | Primary |
Addresses
Primary practice location
1101 B Gale Wilson Blvd
Fairfield, CA 94533-3700
Mailing address
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 646-4150
Other names 1
- Kathleen Ann Gorski
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3342 | CA | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Solano Diagnostics Partners a Calif Limited Partnership | Past | Accepting new patients | |
| Northbay Physicians Surgery Center LLC | Past | Accepting new patients | |
| Quantum Medical Radiology PC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/UMZ-Uxn6V9x08sH5gCnG-5yPg9ZX7et6/
Organizations & group practices 3
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.
-
- Ambulatory Surgical Clinic/Center
- Vacaville, CA
- NPI 1003015843
-
- Diagnostic Radiology Physician
- Fairfield, CA
- NPI 1811940661
-
- Diagnostic Radiology Physician
- Smyrna, GA
- NPI 1164475869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399593600000",
"number": "1629489802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 B GALE WILSON BLVD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333552",
"telephone_number": "707-646-4150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 B GALE WILSON BLVD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333700",
"telephone_number": "707-646-4150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KATHLEEN",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-09",
"last_updated": "2014-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "3342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHLEEN",
"last_name": "GORSKI",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.