Active NPI
Gordon E Smith, PT
- Physical Therapist
- S Yarmouth, MA
National Provider Identifier
1174504435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7108
- Practice address
- 833 Main St
Rte 28
S Yarmouth, MA 02664-5254 - Phone
- (508) 394-1353
- Fax
- (508) 398-2866
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7108 | MA | Primary |
Addresses
Primary practice location
833 Main St
Rte 28
S Yarmouth, MA 02664-5254
Mailing address
833 Main St
Rte 28
S Yarmouth, MA 02664-5254
Phone (508) 394-1353
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0365696 | Medicaid | MA | |
| BCBS OF MA | Other | MA | Y66769 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7108 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bass River Healthcare Associates, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- S Yarmouth, MA
- NPI 1225010192
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1174504435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 MAIN ST",
"address_2": "RTE 28",
"city": "S YARMOUTH",
"state": "MA",
"postal_code": "026645254",
"telephone_number": "508-394-1353",
"fax_number": "508-398-2866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 MAIN ST",
"address_2": "RTE 28",
"city": "S YARMOUTH",
"state": "MA",
"postal_code": "026645254",
"telephone_number": "508-394-1353",
"fax_number": "508-398-2866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "GORDON",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "7108",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0365696",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "Y66769",
"identifier": "BCBS OF MA",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in S Yarmouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.