Ethan Smith, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

2350 S Wade Dr Unit 2090
Gilbert, AZ 85295-0453

Phone

(801) 372-7114

NPI assigned

Jan 19, 2024

Last updated

Jan 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amy Grulke, PLLC

  dba Arbor Therapy

  • Speech-Language Pathologist
  • Chandler, AZ
  • NPI 1316464795

  Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1942061528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 S WADE DR UNIT 2090",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950453",
            "telephone_number": "801-372-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 S WADE DR UNIT 2090",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950453",
            "telephone_number": "801-372-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ETHAN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Smith
• Ciji S Smith, FNP-C
• Danielle McKenzie Smith, M.S.
• Douglas Lloyd Smith, D.D.S.
• Emily Smith
• Euly Cecille Smith
• Gary A Smith, M.D.
• Gregory P Smith, DDS
• Heather Annette Smith, FNP-C
• Jacqueline Smith

• Occupational Therapist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.