Shannon Lynn Smith, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

045043 Issued in NY

Practice address

4721 Transit Rd
Depew, NY 14043-4898

Phone

(716) 656-1880

NPI assigned

Aug 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1083227185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 KELLYBROOK CT",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142244404",
            "telephone_number": "716-868-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 TRANSIT RD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140434898",
            "telephone_number": "716-656-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANNON",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297742",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward J Slowinski
• Angela Rose Smith, LMT
• Brian Smith, RPH
• Colin Michael Smith
• Kyerra Smith, DPT
• Allison M. Smythe, MS, OTR/L
• Samantha Snyder
• Christina Sobieski, MSED
• Soper Chiropractic, PLLC
• Southeast Community Work Center Inc

• Physical Therapist in Depew, NY
• Providers in Depew, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.