Individual provider Active NPI

Daniel Smith, PT.DPT

  • Physical Therapist
  • Bend, OR
National Provider Identifier
1073146882
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
65671 Issued in OR
Practice address
205 SE Wilson Ave Ste 1
Bend, OR 97702-1799
Phone
(206) 672-0145
Fax
(855) 564-1831
NPI assigned
Feb 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 65671 OR Primary

Addresses

Primary practice location

205 SE Wilson Ave Ste 1
Bend, OR 97702-1799

Mailing address

10564 5TH Ave NE Ste 405
Seattle, WA 98125-7200
Phone (206) 672-0145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200330003230 WY Practitioner - Physical Therapist in Private Practice 6204265002 Reassigns benefits to 1 organization
I20250505000786 OR Practitioner - Physical Therapist in Private Practice 6204265002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vestibular Therapy Specialists LLCGroup PAC ID 9537545850, 6 clinicians

Practice addresses (Care Compare)

205 SE Wilson Ave
Suite 1
Bend, OR 97702-1799
Phone (541) 639-4598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
65671ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Therapy Group Limited Partnership CurrentSince Jun 7, 2021 Accepting new patients
Fremont Therapy Group Limited Partnership Physical Therapist CurrentSince Jun 7, 2021 Accepting new patients
Holistic Pain Management of Wyoming, LLC PastSince Feb 1, 2020 Accepting new patients

Locations

8168 State Highway 789
Lander, WY 82520
Phone (307) 332-5240

2002 W Sunset Dr
Ste 1
Riverton, WY 82501
Phone (307) 856-7021

1401 Gateway Blvd
Unit 2
Rock Springs, WY 82901
Phone (307) 352-3626

Organizations & group practices 4

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1073146882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10564 5TH AVE NE STE 405",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257200",
            "telephone_number": "206-672-0145",
            "fax_number": "855-564-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SE WILSON AVE STE 1",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021799",
            "telephone_number": "206-672-0145",
            "fax_number": "855-564-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIEL",
        "credential": "PT.DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-20",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.