Active NPI
Jason Kirk Smith
- Occupational Therapist
- Hartville, MO
National Provider Identifier
1801096631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2005033952
- Practice address
- 649 W Rolla St
Hartville, MO 65667-8221 - Phone
- (417) 741-6192
- NPI assigned
- Jul 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2005033952 | MO | Primary |
Addresses
Primary practice location
649 W Rolla St
Hartville, MO 65667-8221
Mailing address
1061 Morningside Rd
Seymour, MO 65746-8067
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
| License | State | Type | Specialty |
|---|---|---|---|
| 414 | NE | MD | Counselor |
| 2005033952 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1801096631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 MORNINGSIDE RD",
"city": "SEYMOUR",
"state": "MO",
"postal_code": "657468067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "649 W ROLLA ST",
"city": "HARTVILLE",
"state": "MO",
"postal_code": "656678221",
"telephone_number": "417-741-6192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JASON",
"middle_name": "KIRK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-19",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2005033952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.