NPIMap

Individual provider Active NPI

Scott Smolder

  • Orthopedic Physical Therapist
  • Charleston, WV
National Provider Identifier
1003462250
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
002422 Issued in WV
Practice address
400 Tracy Way Ste 100
Charleston, WV 25311-1280
Phone
(304) 720-0205
NPI assigned
Aug 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X
Orthopedic Physical Therapist 2251X0800X 002422 WV Primary

Addresses

Primary practice location

400 Tracy Way Ste 100
Charleston, WV 25311-1280

Mailing address

617 Crystal Springs Dr
Winfield, WV 25213-8616

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
002422WVMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care at Home of West Virginia, LLC PastSince Aug 18, 2019 Accepting new patients
Mountaineer Homecare, LLC PastSince Aug 18, 2019 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1003462250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 CRYSTAL SPRINGS DR",
            "city": "WINFIELD",
            "state": "WV",
            "postal_code": "252138616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TRACY WAY STE 100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111280",
            "telephone_number": "304-720-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLDER",
        "first_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WV",
            "license": "002422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.