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NPI Code Detail

MEDICARE: ALEXANDRIA NICOLE SMALLS

MEDICARE: ALEXANDRIA NICOLE SMALLS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOTA.5521SC

General Provider Information

NPI Number : 1619802279
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRIA NICOLE SMALLS
Provider Business Mailing Address
First Line : 611 CLIMBING ROSE BLVD APT E
Second Line :
City : GRANITEVILLE
State : SC
Zip : 29829-4110
Country : US
Telephone Number : 803-514-6407
Fax Number :
Provider Business Practice Location Address
First Line : 350 AUSTIN GRAYBILL RD
Second Line :
City : NORTH AUGUSTA
State : SC
Zip : 29860-9251
Country : US
Telephone Number : 803-278-4272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

Similar Medicare Providers

1750322400 — MR. JOSEF BEETHOVEN JACOBSON D.P.T.
Practice Location Address:
350 AUSTIN GRAYBILL RD
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Practice Fax: 803-278-1794
1205851441 — NHC HEALTHCARE-NORTH AUGUSTA LLC
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Practice Fax:
1952494338 — KACY MOSES GUSTAFSON COTA/L
Practice Location Address:
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Practice Fax:
1538252820 — MRS. SHANNON RAYBON MCCASLAN COTA/L
Practice Location Address:
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29860-9251
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Practice Fax:
1558454850 — MRS. SHARON H BELL PTA
Practice Location Address:
350 AUSTIN GRAYBILL RD
NORTH AUGUSTA, SC
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Practice Fax:
1558454504 — MRS. NICHELLE BLACKWELL GRANT OTR/L
Practice Location Address:
350 AUSTIN GRAYBILL RD
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Practice Fax:

Directions to “ ALEXANDRIA NICOLE SMALLS ” Practice Location

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