Jennifer Tynette Smith, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT010029 Issued in GA

Practice address

3455 Peachtree Pkwy
Suite 206
Suwanee, GA 30024-9104

Phone

(678) 473-1081

Fax

(678) 473-1082

NPI assigned

Aug 18, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Tynette Whitlock Former name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Lilburn, GA
  • NPI 1760568257
  Medicare reassignment NPD
• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1134434897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 PEACHTREE PKWY",
            "address_2": "SUITE 206",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249104",
            "telephone_number": "678-473-1081",
            "fax_number": "678-473-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "TYNETTE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WHITLOCK",
            "middle_name": "TYNETTE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexis Nicole Smith
• Darvanie Smith, FNP
• Davis Smith, D.M.D.
• Emily Anne Smith, BA, RBT
• Hensel Smith, RBT
• Joel Anthony Smith, PTA
• Kristen Smith, PTA
• Shakhirya Satomi Smith
• Tetyana Tsishenko Smith, LMT
• Jovanna Marie Snead, BA

• Physical Therapist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.