Active NPI
Chandra Faye Smith, OTR/L
- Occupational Therapist
- Effingham, IL
National Provider Identifier
1821759150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056014048
- Practice address
- 503 N Maple St
Effingham, IL 62401-2099 - Phone
- (217) 342-2121
- NPI assigned
- Jan 8, 2022
- Sex
- Female
- 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 | 056014048 | IL | Primary |
Addresses
Primary practice location
503 N Maple St
Effingham, IL 62401-2099
Mailing address
4545 E 1000TH Ave
Altamont, IL 62411-3414
Phone (618) 322-8588
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 |
|---|---|---|---|
| 056014048 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641600000000",
"number": "1821759150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4545 E 1000TH AVE",
"city": "ALTAMONT",
"state": "IL",
"postal_code": "624113414",
"telephone_number": "618-322-8588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 N MAPLE ST",
"city": "EFFINGHAM",
"state": "IL",
"postal_code": "624012099",
"telephone_number": "217-342-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "CHANDRA",
"middle_name": "FAYE",
"name_prefix": "Miss",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-08",
"last_updated": "2022-01-08",
"certification_date": "2022-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056014048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Effingham, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.