Brandon R Smith, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5660 Issued in ME

Practice address

248 State St Ste 3a
Ellsworth, ME 04605-1850

Phone

(207) 667-4278

Fax

(207) 667-4279

NPI assigned

Sep 15, 2020

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

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": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1376158469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 STATE ST STE 3A",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051850",
            "telephone_number": "207-667-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 STATE ST STE 3A",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051850",
            "telephone_number": "207-667-4278",
            "fax_number": "207-667-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRANDON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT5660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davor Graham Sklizovic, M.D.
• Mica T. Slaven-Lamothe, LCSW, MHRT-CSP
• Shannon Lee Small, CADC
• Petr Smejkal, MD
• Smile Design Ellsworth, PC
• Erin Smith
• Sally Linda Smith, LCSW
• Special Children'S Friends, Inc.
• Jessica Spevak, CCC-SLP
• Kriste Bouvier Sprague, PH.D

• Physical Therapist in Ellsworth, ME
• Providers in Ellsworth, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.