Individual provider Active NPI

Tiffanyann Teguin Smith, CPTA

  • Physical Therapy Assistant
  • Netawaka, KS
National Provider Identifier
1104620509
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
14-03979 Issued in KS
Practice address
233 White Way St
Netawaka, KS 66516-9323
Phone
(785) 933-2086
Fax
(785) 370-0768
NPI assigned
Apr 3, 2025
Last updated
Apr 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 14-03979 KS Primary

Addresses

Primary practice location

233 White Way St
Netawaka, KS 66516-9323

Mailing address

425 Illinois Ave
Holton, KS 66436-2108
Phone (785) 851-7176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14-03979KSMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physical & Respiratory Therapy Services LLC CurrentSince Apr 6, 2025 Accepting new patients

Locations

233 White Way St
Netawaka, KS 66516
Phone (785) 285-0720

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1104620509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ILLINOIS AVE",
            "city": "HOLTON",
            "state": "KS",
            "postal_code": "664362108",
            "telephone_number": "785-851-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 WHITE WAY ST",
            "city": "NETAWAKA",
            "state": "KS",
            "postal_code": "665169323",
            "telephone_number": "785-933-2086",
            "fax_number": "785-370-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIFFANYANN",
        "middle_name": "TEGUIN",
        "credential": "CPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "14-03979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Netawaka, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.