Active NPI
Lacey Smith
- Occupational Therapy Assistant
- Philadelphia, PA
National Provider Identifier
1851894034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OP008943
- Practice address
- 650 Edison Ave
Philadelphia, PA 19116-1237 - Phone
- (215) 856-5766
- NPI assigned
- Mar 14, 2018
- 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 Therapy Assistant | 224Z00000X | OP008943 | PA | Primary |
Addresses
Primary practice location
650 Edison Ave
Philadelphia, PA 19116-1237
Mailing address
650 Edison Ave
Philadelphia, PA 19116-1237
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 |
|---|---|---|---|
| OP008943 | PA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520985600000",
"number": "1851894034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 EDISON AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191161237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 EDISON AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191161237",
"telephone_number": "215-856-5766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "LACEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-14",
"last_updated": "2018-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "PA",
"license": "OP008943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.