Mallory C Smith, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT3874 Issued in MS

Practice address

960 Commonwealth Blvd
Tupelo, MS 38804-3880

Phone

(662) 260-3789

Fax

(662) 260-3790

NPI assigned

Jul 27, 2021

Last updated

Jul 27, 2021By the provider in NPPES

Sex

Female

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 MS

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dpti Elite Physical Therapy LLCGroup PAC ID 0547579401, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Dpti Elite Physical Therapy LLC

  • Physical Therapist
  • Saltillo, MS
  • NPI 1386010718
  Medicare reassignment Care Compare group NPD
• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Louisville, MS
  • NPI 1952732448

  Occupational Therapist

  Medicare reassignment NPD
• Dpti Elite Physical Therapy LLC

  • Physical Therapist
  • Baldwyn, MS
  • NPI 1013383496

  Occupational Therapist

  NPD
• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Crystal Springs, MS
  • NPI 1801333521
  NPD (past)

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1972276889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-206-4158",
            "fax_number": "717-773-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 COMMONWEALTH BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388043880",
            "telephone_number": "662-260-3789",
            "fax_number": "662-260-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MALLORY",
        "middle_name": "C",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT3874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline A Smith
• John Smith, M.S., CCC-SLP
• John Patrick Smith, CP
• Kiyanda Smith
• Lakasha Smith
• Micheala Smith
• Niekya Smith
• Niki Smith
• Robert Brasfield Smith, M.D.
• Robert James Smith, LCSW

• Occupational Therapist in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.