SMPT Physical Therapy & Wellness LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SMPT PHYSICAL THERAPY & WELLNESS LLC

Practice address

865 Vintage Dr
Mooresville, NC 28115-4701

Phone

(704) 941-5677

NPI assigned

Mar 15, 2024

Organization subpart

No

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

Authorized official

Name

Shawn M. Minick, MPTNPI 1164558276

Title

Owner

Phone

(704) 941-5677

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn Micheal Minick, PT

  • Orthopedic Physical Therapist
  • Statesville, NC
  • NPI 1164558276
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1336908011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 VINTAGE DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281154701",
            "telephone_number": "704-941-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 VINTAGE DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281154701",
            "telephone_number": "704-941-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMPT PHYSICAL THERAPY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "MINICK",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-941-5677",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristie D. Smith, ARNP
• Lydia Smith, OT/L
• Robert Kevin Smith, PHARM D, CGP, FASCP
• Samuel Clarkman Smith, DDS
• Shelby Smith
• Angela Shirk Sneed, ATC, LAT
• SNH SE Mooresville Tenant LLC
• Shannon Margaret Snipe, D.M.D
• Petros Agapios Sofroniou, MD
• Chloe Solek, MA, LMFTA

• Physical Therapist in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.