Micah Brooke Woods Smith, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT7551 Issued in MS

Practice address

201 South Brooks Ave
Pelahatchie, MS 39145-0001

Phone

(601) 759-5006

Fax

(601) 759-5014

NPI assigned

Nov 13, 2024

Last updated

Nov 13, 2024By 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 MS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance Therapy LLCGroup PAC ID 7012971047, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Performance Therapy LLC

  • Physical Therapist
  • Philadelphia, MS
  • NPI 1851427132
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1225852528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W BEACON ST",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393503229",
            "telephone_number": "601-650-0002",
            "fax_number": "601-898-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SOUTH BROOKS AVE",
            "city": "PELAHATCHIE",
            "state": "MS",
            "postal_code": "391450001",
            "telephone_number": "601-759-5006",
            "fax_number": "601-759-5014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICAH BROOKE",
        "middle_name": "WOODS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT7551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Justin Rhodes
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• Nicholas Cody Shaw, ATC
• Chrysanne Shelton
• Alicia Marie Slater, LMFT
• Bradley Emmett Williams, DMD

• Physical Therapist in Pelahatchie, MS
• Providers in Pelahatchie, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.