Individual provider Active NPI

Glison Angela Lehto Smith, DPT

  • Physical Therapist
  • Lewiston, ME
National Provider Identifier
1245666767
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4062 Issued in ME
Practice address
1977 Lisbon Rd
Lewiston, ME 04240-1415
Phone
(207) 784-3400
Fax
(207) 784-6400
NPI assigned
Sep 16, 2013
Last updated
Aug 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4062 ME Primary

Addresses

Primary practice location

1977 Lisbon Rd
Lewiston, ME 04240-1415

Mailing address

10 Furbush St
Lewiston, ME 04240-3812
Phone (207) 441-6189

Other practice location 1

128 Middle St
Farmington, ME 04938-6937
Phone (207) 778-6469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140109000229 ME Practitioner - Physical Therapist in Private Practice 9931337490 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Mar 1, 2020 Accepting new patients
Head to Toe Physical Therapy Physical Therapist CurrentSince Aug 27, 2019 Accepting new patients
Central Maine Medical Center CurrentSince Mar 1, 2020 Accepting new patients
Elevation Physical Therapy Physical Therapist CurrentSince Aug 2, 2020 Accepting new patients

Locations

128 Middle St
Farmington, ME 04938
Phone (207) 778-6469

1977 Lisbon Rd
Lewiston, ME 04240
Phone (207) 784-3400

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1245666767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FURBUSH ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042403812",
            "telephone_number": "207-441-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 LISBON RD",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042401415",
            "telephone_number": "207-784-3400",
            "fax_number": "207-784-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 Middle St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "ME",
            "postal_code": "049386937",
            "country_code": "US",
            "telephone_number": "207-778-6469",
            "fax_number": "207-778-3486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GLISON",
        "middle_name": "ANGELA LEHTO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT4062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.