Nicole Smith

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTT37296 Issued in FL

Practice address

3903 Northdale Blvd Ste 111W
Tampa, FL 33624-1853

Phone

(813) 418-7350

NPI assigned

Jun 16, 2021

Sex

Female

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 FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimal Performance and Physical Therapies Northdale LLCGroup PAC ID 0749317709, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Optimal Performance and Physical Therapies Northdale LLC

  • Physical Therapist
  • Tampa, FL
  • NPI 1740511195
  Medicare reassignment Care Compare group NPD
• Optimal Performance and Physical Therapies Northdale LLC

  • Physical Therapy Clinic/Center
  • Tampa, FL
  • NPI 1093399347

  Physical Therapist

  NPD

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1083282974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21756 STATE ROAD 54 STE 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492905",
            "telephone_number": "727-475-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 NORTHDALE BLVD STE 111W",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241853",
            "telephone_number": "813-418-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PTT37296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan A Smith, PA-C
• Melanie Lynn Smith, DPT
• Michele Vinet Smith
• Michelle Ann Smith
• Nicholas Smith
• Noelle Bassi Smith, PHD
• Pamela Quyen Smith, PHARMD
• Parinita Shanta Smith, P.T.
• Paul D Smith, MD
• Philip Walter Smith, P.T.

• Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.