Individual provider Active NPI

Angelina Smith, OTR/L

  • Pediatric Occupational Therapist
  • Niles, OH
National Provider Identifier
1730683293
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT012371 Issued in OH
Practice address
950 Youngstown Warren Rd Ste a
Niles, OH 44446-4626
Phone
(330) 505-1606
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT012371 OH Primary
Pediatric Occupational Therapist 225XP0200X OT.0005381 CO

Addresses

Primary practice location

950 Youngstown Warren Rd Ste a
Niles, OH 44446-4626

Mailing address

950 Youngstown Warren Rd Ste a
Niles, OH 44446-4626
Phone (330) 505-1606

Other practice location 1

8561 Market St
Boardman, OH 44512-6727
Phone (309) 532-3833

Other names 1

  • Angelina Gresko Former 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.0005381COMDPediatric Occupational Therapist
OT012371OHMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Choice LLC CurrentSince Jan 1, 2025 Accepting new patients
Aaris Therapy Group, Inc Pediatrics CurrentSince May 18, 2025 Accepting new patients
Lock and Key ABA Therapy Group PastSince Jan 1, 2025 Accepting new patients

Locations

950 Youngstown Warren Rd
Ste A
Niles, OH 44446
Phone (330) 505-1606

8561 Market St
Youngstown, OH 44512
Phone (330) 953-2383

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.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1730683293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 YOUNGSTOWN WARREN RD STE A",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444464626",
            "telephone_number": "330-505-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 YOUNGSTOWN WARREN RD STE A",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444464626",
            "telephone_number": "330-505-1606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8561 Market St",
            "address_purpose": "LOCATION",
            "city": "Boardman",
            "state": "OH",
            "postal_code": "445126727",
            "country_code": "US",
            "telephone_number": "309-532-3833",
            "fax_number": "330-953-2384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANGELINA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OH",
            "license": "OT012371",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CO",
            "license": "OT.0005381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELINA",
            "last_name": "GRESKO",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Niles, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.