Individual provider Active NPI

Caitlyn Edna Smith

  • Occupational Therapist
  • Lake Hiawatha, NJ
National Provider Identifier
1720752371
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00945200 Issued in NJ
Practice address
28 Pawnee Ave
Lake Hiawatha, NJ 07034
Phone
(973) 294-9320
NPI assigned
Aug 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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 46TR00945200 NJ Primary

Addresses

Primary practice location

28 Pawnee Ave
Lake Hiawatha, NJ 07034

Mailing address

28 Pawnee Ave
Lake Hiawatha, NJ 07034
Phone (973) 294-9320

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
46TR00945200NJMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1720752371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 PAWNEE AVE",
            "city": "LAKE HIAWATHA",
            "state": "NJ",
            "postal_code": "07034",
            "telephone_number": "973-294-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 PAWNEE AVE",
            "city": "LAKE HIAWATHA",
            "state": "NJ",
            "postal_code": "07034",
            "telephone_number": "973-294-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAITLYN",
        "middle_name": "EDNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00945200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Hiawatha, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.