Stephen D Smith, PT, DPT, SCS, CSCS

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

PT872071 Issued in DC

Practice address

6355 Willowfield Way
Springfield, VA 22150-1038

Phone

(623) 308-4573

NPI assigned

Aug 20, 2006

Reactivated

Oct 28, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1376879130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614838",
            "telephone_number": "850-916-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 WILLOWFIELD WAY",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221501038",
            "telephone_number": "623-308-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "replacement_npi": "1376879130",
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "credential": "PT, DPT, SCS, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "deactivation_date": "2009-09-25",
        "reactivation_date": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "FL",
            "license": "23451",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "DC",
            "license": "PT872071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Marie Smith, MD
• Kyrsten Lee Smith
• Lori Cynthia Smith, MS CCC SLP
• Patricia Louise Smith, OTR
• Stacey Smith
• Vicki Michelle Smith
• Terri L Snyder, PT
• Leigha Sochurek, BCBA
• Sofia Rizwan MD, PC
• Sonrisas and Smiles Dental Care, PLLC

• Sports Physical Therapist in Springfield, VA
• Providers in Springfield, VA by specialty
• Sports Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.