Judith Ellen Smerilson, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT20436 Issued in FL

Practice address

602 Vonderburg Dr
Suite 201
Brandon, FL 33511-5900

Phone

(813) 653-1149

NPI assigned

Nov 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1124208798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR",
            "address_2": "SUITE 201",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115900",
            "telephone_number": "813-653-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR",
            "address_2": "SUITE 201",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115900",
            "telephone_number": "813-653-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMERILSON",
        "first_name": "JUDITH",
        "middle_name": "ELLEN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-12",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT7732",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20436",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": "PT20436",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015408900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016133700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eden Jailene Slacum
• Sonya Contre' Sleem, M.A.CCC-SLP
• Sleepwellsolutionsofflorida LLC
• Laura Slevin, M.S., CCC-SLP
• Amanda Sligh
• Chasity Marsha'E Smith-Pedersen
• Alison Ulsh Smith, M.S., CCC-SLP
• Amanda Smith
• Crystal Smith, APRN
• Erin Marie Smith, PSY.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.