Kenneth W Smith PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0963 Issued in OR

Legal business name

KENNETH W SMITH PT

Doing business as

Prineville Physical Therapy

Practice address

1251 NE Elm St Ste 2a
Prineville, OR 97754-3143

Phone

(541) 447-6846

Fax

(541) 447-1243

NPI assigned

Sep 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth W Smith, P.T.NPI 1184773954

Title

Owner/Physical Therapist

Phone

(541) 447-6846

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prineville Physical Therapy Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth W Smith, P.T.

  • Physical Therapist
  • Prineville, OR
  • NPI 1184773954
  NPD (past) Authorized official

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1255527636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 NE ELM ST STE 2A",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977543143",
            "telephone_number": "541-447-6846",
            "fax_number": "541-447-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 NE ELM ST STE 2A",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977543143",
            "telephone_number": "541-447-6846",
            "fax_number": "541-447-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH W SMITH PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "541-447-6846",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "0963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160010",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prineville Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristina Marie Keller, FNP
• Kelly Valente LMFT LLC
• Shawna Kelly-Wickersheim, CPM
• Christine Kenline
• Heather Kennedy
• Jennifer Lee Kerber, BA, QMHA, PSST
• Sarah Deniece Kershner, NP
• Jessica King, MA, MS
• Maggie J King, MD
• Sally Lynn Klann, LMT

• Physical Therapist in Prineville, OR
• Providers in Prineville, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.