Individual provider Active NPI

Christine Marie Smetek, COTA

  • Occupational Therapy Assistant
  • Cudahy, WI
National Provider Identifier
1780017269
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5019-27 Issued in WI
Practice address
3642 E Martin Ave
Cudahy, WI 53110-1908
Phone
(414) 807-0667
NPI assigned
Aug 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5019-27 WI Primary

Addresses

Primary practice location

3642 E Martin Ave
Cudahy, WI 53110-1908

Mailing address

3642 E Martin Ave
Cudahy, WI 53110-1908
Phone (414) 807-0667

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

LicenseStateTypeSpecialty
5019-27WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1780017269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3642 E MARTIN AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531101908",
            "telephone_number": "414-807-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3642 E MARTIN AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531101908",
            "telephone_number": "414-807-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMETEK",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "5019-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cudahy, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.