Individual provider Active NPI

Renee M Smith, DPT

  • Physical Therapist
  • Palm Desert, CA
National Provider Identifier
1366982183
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
293003 Issued in CA
Practice address
73345 Highway 111 Ste 103
Palm Desert, CA 92260-3909
Phone
(760) 674-0675
NPI assigned
Feb 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 293003 CA Primary

Addresses

Primary practice location

73345 Highway 111 Ste 103
Palm Desert, CA 92260-3909

Mailing address

24630 Washington Ave Ste 200
Murrieta, CA 92562-6177
Phone (951) 696-9353

Other practice location 1

1695 S San Jacinto Ave Ste C
San Jacinto, CA 92583-5103
Phone (951) 665-1510

Other practice location 2

23100 Eucalyptus Ave
Moreno Valley, CA 92553-5439
Phone (951) 485-4594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211020001464 AZ Practitioner - Physical Therapist in Private Practice 3779842430 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
293003CAMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: renee.smith.p4@direct.caremorewest.nextgenshare.com
  • Direct secure messaging: renee.smith.1@32527.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1366982183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE STE 200",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626177",
            "telephone_number": "951-696-9353",
            "fax_number": "951-973-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73345 HIGHWAY 111 STE 103",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603909",
            "telephone_number": "760-674-0675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1695 S San Jacinto Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "San Jacinto",
            "state": "CA",
            "postal_code": "925835103",
            "country_code": "US",
            "telephone_number": "951-665-1510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23100 Eucalyptus Ave",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925535439",
            "country_code": "US",
            "telephone_number": "951-485-4594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RENEE",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.