Individual provider Active NPI

Christina SW Smethie, OTRL CHT

  • Occupational Therapist
  • St Augustine, FL
National Provider Identifier
1700988557
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 731 Issued in FL
Practice address
1690 US Highway 1 S Ste a
St Augustine, FL 32084-6024
Phone
(904) 810-2101
Fax
(904) 810-2106
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT 731 FL Primary

Addresses

Primary practice location

1690 US Highway 1 S Ste a
St Augustine, FL 32084-6024

Mailing address

208 Moses Creek Blvd
St Augustine, FL 32086-5675
Phone (561) 319-7361

Other identifiers 3

IdentifierTypeStateIssuer
AG424ZOtherFLMEDICARE PTAN
AG243OtherFLMEDICARE PTAN GROUP
880568700MedicaidFL

Other names 1

  • Ms. Christina S Wiley Smethie Other name

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

LicenseStateTypeSpecialty
OT 731FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1700988557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MOSES CREEK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865675",
            "telephone_number": "561-319-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 US HIGHWAY 1 S STE A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846024",
            "telephone_number": "904-810-2101",
            "fax_number": "904-810-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMETHIE",
        "first_name": "CHRISTINA",
        "middle_name": "SW",
        "name_prefix": "Ms.",
        "credential": "OTRL  CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AG424Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN GROUP",
            "identifier": "AG243",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880568700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "WILEY SMETHIE",
            "middle_name": "S",
            "prefix": "MS.",
            "credential": "OTRL CHT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.