Kathryn G Smith, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MASG-1268 Issued in ID

Practice address

5909 W State St
Boise, ID 83703-3039

Phone

(208) 343-7700

Fax

(208) 331-2591

NPI assigned

Nov 18, 2013

Last updated

Nov 18, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peregrine Physical Therapy LLC

  dba Physical Therapy 180

  • Physical Therapist
  • Boise, ID
  • NPI 1942128137
  NPD (past)
• Physical Therapy 180 LLC

  dba Physical Therapy 180

  • Physical Therapist
  • Boise, ID
  • NPI 1669696910
  NPD (past)

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384732800000",
    "number": "1235569864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5909 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033039",
            "telephone_number": "208-343-7700",
            "fax_number": "208-331-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5909 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033039",
            "telephone_number": "208-343-7700",
            "fax_number": "208-331-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHRYN",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MASG-1268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jim B Smith, LMSW
• Jocelynn Smith
• Kaitlyn Rose Smith, M.S., CF-SLP
• Kameryn Loraine Smith
• Kapka Zlatkova Smith, LMSW
• Kelsey Hamilton Smith, NP
• Kenneth Wayne Smith, COTA/L
• Kevin James Smith, LMSW
• Kristie Opal Smith, AUD
• Laura Kay Smith, DTR

• Massage Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.