Organization Active NPI

Ethos Pediatric Therapy LLC

  • Occupational Therapist
  • Plymouth, MI
National Provider Identifier
1629913561
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
ETHOS PEDIATRIC THERAPY LLC
Practice address
44191 Plymouth Oaks Blvd Ste 400
Plymouth, MI 48170-6532
Phone
(734) 463-3007
Fax
(734) 203-0901
NPI assigned
Apr 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Mr. Bradley Smith, DPTNPI 1902233000
Title
Director
Phone
(734) 463-3007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

44191 Plymouth Oaks Blvd Ste 400
Plymouth, MI 48170-6532

Mailing address

44191 Plymouth Oaks Blvd Ste 400
Plymouth, MI 48170-6532
Phone (734) 463-3007

National Provider Directory

National Provider Directory

Locations

44191 Plymouth Oaks Blvd
Ste 400
Plymouth, MI 48170
Phone (734) 259-7103

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1629913561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44191 PLYMOUTH OAKS BLVD STE 400",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706532",
            "telephone_number": "734-463-3007",
            "fax_number": "734-203-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44191 PLYMOUTH OAKS BLVD STE 400",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706532",
            "telephone_number": "734-463-3007",
            "fax_number": "734-203-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "734-463-3007",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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.