Chanel Mone Smith, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1394401 Issued in TX

Practice address

1000 Saint Louis Ave Ste 102
Fort Worth, TX 76104-3377

Phone

(817) 921-5020

NPI assigned

Jul 24, 2024

Sex

Female

Sole proprietor

Yes

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

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": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1124856752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 SPRING VALLEY RD STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752541944",
            "telephone_number": "469-291-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SAINT LOUIS AVE STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043377",
            "telephone_number": "817-921-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHANEL",
        "middle_name": "MONE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1394401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb Smith, MD
• Carla Michelle Smith
• Carol Jean Smith, PT, DPT
• Caroline C Smith, PHLEBOTOMIST
• Caylee Jordan Smith, D.C
• Chera M Smith, PA-C
• Claire Smith, MS, CCC-SLP
• Cody Wayne Smith, CST, CSFA
• Crystal Smith
• Damian Smith, PHARM D

• Physical Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.