Charles Larue Smith Jr., MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00976600 Issued in NJ

Practice address

77 Madison Ave
Morristown, NJ 07960-7330

Phone

(973) 540-9800

NPI assigned

Jun 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab Network IncGroup PAC ID 3476539776, 658 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 and National Provider Directory roles.

• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274
  Medicare reassignment Care Compare group NPD
• Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cranford, NJ
  • NPI 1699590265

  Physical Therapist

  NPD

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295937050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 VILLAGE GRN APT L",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "078281355",
            "telephone_number": "917-613-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MADISON AVE",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079607330",
            "telephone_number": "973-540-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "LARUE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00976600",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT-01355L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Sloven
• Jennifer Smedberg, MSW, LCSW
• Janice Marie Smiell, M.D.
• Brandon Christopher Smith
• Brian L Smith, M.D
• Elizabeth Marie Smith, PSY.D.
• Janice Ann Smith, APRNC
• Kristin Smith, DO
• Margaret C Smith, MSW, LCSW
• Nancy C Smith, DC

• Physical Therapist in Morristown, NJ
• Providers in Morristown, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.