Katelyn J Smith, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1277063 Issued in TX

Practice address

12315 Judson Rd
Live Oak, TX 78233-3277

Phone

(210) 599-3090

Fax

(210) 599-4088

NPI assigned

Aug 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Katelyn Skinner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

85.56 of 100Reported as group

Quality

89.48

Improvement activities

40

Cost

71.16

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 31)

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.

• Ideal Physical Therapy of Texas LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Plano, TX
  • NPI 1538573746
  NPD
• Ideal Physical Therapy of Texas LLC

  • Durable Medical Equipment & Medical Supplies
  • Murphy, TX
  • NPI 1902773161
  NPD

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497916800000",
    "number": "1306213277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12315 JUDSON RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333277",
            "telephone_number": "210-599-3090",
            "fax_number": "210-599-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATELYN",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2017-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "PT 070021791",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1277063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "569447ZK77",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "SKINNER",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Veronica Simpkins, RN
• Sleep and Pulmonary Associates PA
• Aldyn Lee Smith
• Christen Samira Smith, PA-C
• Jessica Smith, BCBA, LBA
• Lesley Lanier Smith, LPC-S
• Tonya Smith
• Malesa Renea Smyth
• Jennifer Andrea Solis, NP-C
• Ismael Tres Sosa, MD

• Physical Therapist in Live Oak, TX
• Providers in Live Oak, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.