Kelli S. Smith, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1180918 Issued in TX

Practice address

1116 Halsell St
Bridgeport, TX 76426-3000

Phone

(940) 683-5575

NPI assigned

Jun 6, 2008

Last updated

Dec 20, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foundation Therapy LLCGroup PAC ID 2466761341, 3 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foundation Therapy LLC

  • Physical Therapy Clinic/Center
  • Bridgeport, TX
  • NPI 1225446669
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1154580983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1402",
            "city": "BRIDGEPORT",
            "state": "TX",
            "postal_code": "764261402",
            "telephone_number": "940-683-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 HALSELL ST",
            "city": "BRIDGEPORT",
            "state": "TX",
            "postal_code": "764263000",
            "telephone_number": "940-683-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLI",
        "middle_name": "S.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1180918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SCC Partners, Inc. (The Residences at Senior Care)
• SCC Partners, Inc. (Senior Care Health and Rehabilitation - Bridgeport)
• Dan C Selz, DDS
• Deborah Selz, DDS
• Emily Kathleen Smith, O.D.
• Alissa Sobieraj, PAC
• Solaris Pharmacy Inc (Solaris Pharmacy)
• Southwest Healthcare Ventures (Cambio Life Recovery Center)
• Michaelyn Stainton
• Steve Longacre M.D. PA

• Physical Therapist in Bridgeport, TX
• Providers in Bridgeport, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.