Individual provider Active NPI

Matthew P Smith, T-DPT

  • Physical Therapist
  • Centerville, OH
National Provider Identifier
1083457287
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT021246 Issued in OH
Practice address
5600 Royalwood Dr
Centerville, OH 45429-6136
Phone
(937) 580-0271
NPI assigned
Jun 15, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

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 PT021246 OH Primary

Addresses

Primary practice location

5600 Royalwood Dr
Centerville, OH 45429-6136

Mailing address

1002 Rainbow CT
Fairborn, OH 45324-6365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240911003647 OH Practitioner - Physical Therapist in Private Practice 4284174616 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT021246OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates of SW Ohio, Inc CurrentSince Jul 1, 2024 Accepting new patients
Orthopedic Associates of S W Ohio Inc, CurrentSince Jul 1, 2024 Accepting new patients

Locations

6551 Centerville Business Pkwy
Ste 120
Dayton, OH 45459
Phone (937) 428-0400

7677 Yankee St
Ste 110
Dayton, OH 45459
Phone (937) 401-6400

4160 Little York Rd
Ste 10
Dayton, OH 45414
Phone 9374159100335

1002 Rainbow Ct
Fairborn, OH 45324

Organizations & group practices 2

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": "1718409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718409600000",
    "number": "1083457287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 RAINBOW CT",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453246365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 ROYALWOOD DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454296136",
            "telephone_number": "937-580-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTHEW",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "T-DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-15",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.