Alex N Smithback, D-PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14166-24 Issued in WI

Practice address

311 N 3Rd Ave
Sturgeon Bay, WI 54235-2401

Phone

(920) 743-0255

Fax

(920) 743-6680

NPI assigned

May 16, 2018

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 WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asmithback187614@direct.thedacare.org

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.

• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment Care Compare group NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390

  Physical Therapist

  NPD
• Bellin Memorial Hospital Inc

  • Orthopaedic Surgery Physician
  • Green Bay, WI
  • NPI 1114398849
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1013407915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N 3RD AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542352401",
            "telephone_number": "920-743-0255",
            "fax_number": "920-743-6680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013505",
            "country_code": "US",
            "telephone_number": "920-433-7822",
            "fax_number": "920-433-3651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140B School Creek Trl",
            "address_purpose": "LOCATION",
            "city": "Luxemburg",
            "state": "WI",
            "postal_code": "542171095",
            "country_code": "US",
            "telephone_number": "920-845-1370",
            "fax_number": "920-845-1379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "831 Parker Ave",
            "address_purpose": "LOCATION",
            "city": "Algoma",
            "state": "WI",
            "postal_code": "542011808",
            "country_code": "US",
            "telephone_number": "920-487-3676",
            "fax_number": "920-487-3084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITHBACK",
        "first_name": "ALEX",
        "middle_name": "N",
        "credential": "D-PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-16",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14166-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Sigmann, M.D.
• Mary Belle Simac, B.S.
• Jessica J Skinner, RN, IBCLC
• Schye D Skinner
• Chanta L Sloma, DACM, LAC
• Judith Sowl, RDN, CD
• Specialized Services, LLC
• Michael R. St Jean, M.D.
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis
• St. Clare Memorial Hospital, Inc

• Physical Therapist in Sturgeon Bay, WI
• Providers in Sturgeon Bay, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.