Kendra Sue Smith, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.013723 Issued in IL

Practice address

3905 W Ernestine Dr
Suite B
Marion, IL 62959-5800

Phone

(618) 993-6237

NPI assigned

Oct 2, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Occupational Performance and Rehab, PC

  • Occupational Therapist
  • Marion, IL
  • NPI 1689746216

  Physical Therapist

  NPD (past)
• Performance Chiropractic of Southern Illinois LLC

  • Chiropractor
  • Marion, IL
  • NPI 1538314414
  NPD (past)
• Southern Illinois Hospital Services

  • Medicare Defined Swing Bed Hospital Unit
  • Murphysboro, IL
  • NPI 1639595036
  NPD (past)
• Southern Illinois Pain Management

  • Specialist
  • Marion, IL
  • NPI 1942227863
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1235222779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 NORTH 12TH STREET",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "62948",
            "telephone_number": "618-988-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 W ERNESTINE DR",
            "address_2": "SUITE B",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595800",
            "telephone_number": "618-993-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENDRA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.013723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Smith
• Jonna Lynn Smith, RPH
• Joshua Smith, PA-C
• Julie Ann Smith
• Katherine Louise Smith
• Kristina Smith, LCSW
• Lindsey Smith, LPN
• Lisa Smith
• Marianne Smith
• Nancy A. Smith, L.C.S.W.

• Physical Therapist in Marion, IL
• Providers in Marion, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.