Stephanie Rose Smith, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

122620 Issued in TX

Practice address

3009 N Prince St # 46
Clovis, NM 88101-3842

Phone

(217) 415-0855

NPI assigned

Dec 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Outside the Box Therapy, LLC

  dba Outside The Box Therapy

  • Pediatric Occupational Therapist
  • Clovis, NM
  • NPI 1427796523

  Single Specialty

  NPD
• Jacqueline Kozak

  • Occupational Medicine Clinic/Center
  • Georgetown, TX
  • NPI 1699482448
  NPD (past)

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689984000000",
    "number": "1760194369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4969 BIG SKY RD",
            "city": "FORT SUMNER",
            "state": "NM",
            "postal_code": "881199120",
            "telephone_number": "806-543-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N PRINCE ST # 46",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881013842",
            "telephone_number": "217-415-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHANIE",
        "middle_name": "ROSE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2023-07-22",
        "certification_date": "2023-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "122620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Ann Smith, BS
• Jade Smith
• Marcus Smith, LPCC
• Maria D Smith, ADMIN ASSIS
• Marvenar Smith, BACHELOR SOCIAL WORK
• Taris Renee Smith, COTA/L
• Katelyn Marie Smyth, RN
• Betty Rae Snipes
• Nathan Snow
• Anita Solveson

• Occupational Therapist in Clovis, NM
• Providers in Clovis, NM by specialty
• Occupational Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.