Derek Miles Smith, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1140028 Issued in TX

Practice address

4780 N Josey LN
Carrollton, TX 75010-4615

Phone

(972) 492-1334

Fax

(972) 492-5174

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Metrocrest Orthopaedics & Sports Medicine

  • Specialist
  • Carrollton, TX
  • NPI 1710030374
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369180800000",
    "number": "1083703490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4780 N JOSEY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104615",
            "telephone_number": "972-492-1334",
            "fax_number": "972-492-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4780 N JOSEY LN",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104615",
            "telephone_number": "972-492-1334",
            "fax_number": "972-492-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DEREK",
        "middle_name": "MILES",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1140028",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1140028",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B - PRIOR TO 2/1/11",
            "identifier": "8D5829",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8T3800",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00954365",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B - EFFECT 3/3/11",
            "identifier": "TXB121221",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS TX - EFFECT 02/01/2011",
            "identifier": "854T69",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Slater, AU.D.
• Smile Dental Care I, PLLC
• Smile Pharmaceutical Inc (Smile Pharmacy)
• Ashley Whitney Smith, LPC
• Bryan Smith
• Erin Elizabeth Smith, OTR
• Jonathan Edward Smith, M.S., CCC-SLP
• Laurie Ann Smith, CRNA
• Matthew T Smith, M.D.
• Natalie U Smith, P.A.-C

• Physical Therapist in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; 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.