Rebel PT, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REBEL PT, LLC

Doing business as

Rebel PT

Practice address

511 Broad St
Fuquay Varina, NC 27526-1707

Phone

(814) 533-1009

NPI assigned

Aug 29, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Courtney Smiach, DPTNPI 1891287215

Title

Owner/Physical Therapist

Phone

(814) 533-1009

Specialties & licenses 1

Addresses

Other names 1

• Rebel PT Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Courtney Lynne Smiach, DPT

  • Physical Therapist
  • Cameron, NC
  • NPI 1891287215
  NPD Authorized official

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1144949561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 LONDON MEADOW WAY",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275264788",
            "telephone_number": "815-533-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 BROAD ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261707",
            "telephone_number": "814-533-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBEL PT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "SMIACH",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "814-533-1009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebel PT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine Smith Raynor, CCC-SLP
• Elizabeth Hurley Raynor, MS, RD, LDN
• Michael Raynor, MS, RD, LDN
• RBC Health Care Soultions Inc
• Realo Discount Drug Stores of Eastern North Carolina Inc (Realo Discount Drugs)
• Hope Renee Rebeor
• Caitlyn Reece, RN, IBCLC
• Jennifer Marie Reed, OTR/L
• Reframing Language LLC
• Lynnette Lister Regan

• Physical Therapy Clinic/Center in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Physical Therapy Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.