Kelly Martin-Smith, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT17216 Issued in CA

Practice address

2015 W Park Ave Ste 16
Redlands, CA 92373-6276

Phone

(909) 307-9121

NPI assigned

Jul 2, 2019

Last updated

Jul 2, 2019By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1376105080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 W PARK AVE STE 16",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736276",
            "telephone_number": "909-307-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 W PARK AVE STE 16",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736276",
            "telephone_number": "909-307-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-SMITH",
        "first_name": "KELLY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT17216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marquee Anesthesia Consultants Inc
• Paul Anthony Marquez, CPHT
• Marelis Marrero, MS, LMFT
• Michael Marroquin, O.D.
• Marta L Cheatham Lott M D Inc
• Janelle Ashly Martin, LMFT122088
• Linda L Martin, M.D.
• Megan F Martineau, LCSW
• Marlene Martinez-Mendoza
• Alejandra Martinez, SLPA

• Physical Therapist in Redlands, CA
• Providers in Redlands, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.