Active NPI
Donneisha Smith, COTA
- Occupational Therapy Assistant
- Monahans, TX
National Provider Identifier
1962894725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 212887
- Practice address
- 1200 W 15TH St
Monahans, TX 79756-8301 - Phone
- (616) 975-5092
- NPI assigned
- Mar 3, 2015
- 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 | 212887 | TX | Primary |
Addresses
Primary practice location
1200 W 15TH St
Monahans, TX 79756-8301
Mailing address
3773 N 58TH Blvd
Milwaukee, WI 53216-2850
Phone (414) 839-4028
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 |
|---|---|---|---|
| 212887 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425340800000",
"number": "1962894725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3773 N 58TH BLVD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532162850",
"telephone_number": "414-839-4028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W 15TH ST",
"city": "MONAHANS",
"state": "TX",
"postal_code": "797568301",
"telephone_number": "616-975-5092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DONNEISHA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-03",
"last_updated": "2015-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "212887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monahans, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.