Amber Dawn Smith, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

32002152A Issued in IN

Practice address

52565 State Road 933
South Bend, IN 46637-3257

Phone

(574) 247-7044

NPI assigned

Jul 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amber Dawn Burns Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1861875890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52565 STATE ROAD 933",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466373257",
            "telephone_number": "574-213-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52565 STATE ROAD 933",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466373257",
            "telephone_number": "574-247-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMBER",
        "middle_name": "DAWN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32002152A",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202007559",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "BURNS",
            "middle_name": "DAWN",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Smeltzer-Carpenter, MA
• Angela Marie Smilgius, LCSW
• Lori Smith-Kaminsky, PHARMD
• Abbee Dallek Smith, LCSW
• Adam Smith, LMHC
• Carlton Smith Jr., OTR/L
• Christopher Joseph Smith, DPT
• David A Smith, PHD, ABPP, HSPP
• Donald W Smith, MD
• Jessica L Smith, LMHCA

• Occupational Therapy Assistant in South Bend, IN
• Providers in South Bend, IN by specialty
• Occupational Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.