Individual provider Active NPI

Ryan Kaye Smith, PT, DPT, OCS

  • Physical Therapist
  • Apple Valley, MN
National Provider Identifier
1053575514
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8133 Issued in MN
Practice address
14655 Galaxie Ave Ste 160
Apple Valley, MN 55124-8602
Phone
(651) 241-3880
Fax
(651) 241-3890
NPI assigned
Jul 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8133 MN Primary

Addresses

Primary practice location

14655 Galaxie Ave Ste 160
Apple Valley, MN 55124-8602

Mailing address

14655 Galaxie Ave Ste 160
Apple Valley, MN 55124-8602
Phone (651) 241-3880

Other practice location 1

800 E 28th St
Minneapolis, MN 55407-3723
Phone (612) 863-4815

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

Interoperability endpoints

  • Direct secure messaging: rsmith70410@excellian.direct.allina.com

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1053575514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14655 GALAXIE AVE STE 160",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248602",
            "telephone_number": "651-241-3880",
            "fax_number": "651-241-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14655 GALAXIE AVE STE 160",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248602",
            "telephone_number": "651-241-3880",
            "fax_number": "651-241-3890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E 28th St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554073723",
            "country_code": "US",
            "telephone_number": "612-863-4815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RYAN",
        "middle_name": "KAYE",
        "name_prefix": "Mr.",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.