Kevin Smith

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10619 Issued in CT

Practice address

5 Pequot Park Rd
Suite 303
Westbrook, CT 06498-2856

Phone

(860) 399-6411

Fax

(860) 399-6822

NPI assigned

Aug 3, 2015

Last updated

Aug 3, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Physical Therapy, LLCGroup PAC ID 7315020005, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Advanced Physical Therapy, LLC

  • Physical Therapist
  • Wolcott, CT
  • NPI 1861677262
  Medicare reassignment Care Compare group
• Integrated Rehabilitation Services, LLC

  • Physical Therapist
  • Vernon, CT
  • NPI 1104867951
  NPD (past)

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1346626264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 N MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071926",
            "telephone_number": "860-409-4595",
            "fax_number": "860-409-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PEQUOT PARK RD",
            "address_2": "SUITE 303",
            "city": "WESTBROOK",
            "state": "CT",
            "postal_code": "064982856",
            "telephone_number": "860-399-6411",
            "fax_number": "860-399-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "10619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Elizabeth Sanchez
• Nilani Shankar, PHD
• Shoreline Foot & Ankle Center, PC
• Jaclyn Skirkanich
• Valerie M Small, M.D.
• Carol Anne Standish, APRN
• Stephen Strong, DPT
• Jennifer Lyn Sutherland, M.D., M.P.H
• Elizabeth Swift, DPT
• Susan Tabele-Kolbenheyer, LPCA

• Physical Therapist in Westbrook, CT
• Providers in Westbrook, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.