Matthew James Smith, PTA ATC

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2123567 Issued in TX

Practice address

22430 Grand Corner Dr
Katy, TX 77494-5718

Phone

(713) 205-7030

NPI assigned

Jan 1, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1577836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577836800000",
    "number": "1225677768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7606 EASTWOOD LAKE LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774072874",
            "telephone_number": "713-205-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22430 GRAND CORNER DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774945718",
            "telephone_number": "713-205-7030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7606 Eastwood Lake Ln",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "774072874",
            "country_code": "US",
            "telephone_number": "713-205-7030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PTA ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-01",
        "last_updated": "2020-01-01",
        "certification_date": "2020-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "TX",
            "license": "AT1201",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2123567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Nichole Smith, AU.D.
• Justin Smith, NP
• Kay Robin Robin Smith
• Kyndal Smith
• Marla Smith, PT
• Pamela Smith, FNP
• Rochell Smith
• Rochelle D Smith, COUNSELOR
• Roger A Smith, MD
• Shanika Carmella Smith, CNA

• Physical Therapy Assistant in Katy, TX
• Providers in Katy, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2020; 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.