Active NPI
Scott Eric Smith, OTR
- Occupational Therapist
- South Haven, MI
National Provider Identifier
1639730948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201002385
- Practice address
- 955 S Bailey Ave
South Haven, MI 49090-6743 - Phone
- (269) 639-2929
- Fax
- (269) 639-2928
- NPI assigned
- Jun 26, 2019
- Sex
- Male
- 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 | 5201002385 | MI | Primary |
Addresses
Primary practice location
955 S Bailey Ave
South Haven, MI 49090-6743
Mailing address
955 S Bailey Ave
South Haven, MI 49090-6743
Phone (269) 639-2929
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 |
|---|---|---|---|
| 5201002385 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561507200000",
"number": "1639730948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "955 S BAILEY AVE",
"city": "SOUTH HAVEN",
"state": "MI",
"postal_code": "490906743",
"telephone_number": "269-639-2929",
"fax_number": "269-639-2928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "955 S BAILEY AVE",
"city": "SOUTH HAVEN",
"state": "MI",
"postal_code": "490906743",
"telephone_number": "269-639-2929",
"fax_number": "269-639-2928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SCOTT",
"middle_name": "ERIC",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-26",
"last_updated": "2019-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201002385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Haven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.