Individual provider Active NPI

David Smith

  • Physical Therapist
  • North East, MD
National Provider Identifier
1407320880
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28369 Issued in MD
Practice address
2540 Pulaski Hwy Ste B
North East, MD 21901-2610
Phone
(410) 339-1960
Fax
(443) 941-9441
NPI assigned
Jan 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X J1-0004025 DE
Physical Therapist 225100000X 28369 MD Primary

Addresses

Primary practice location

2540 Pulaski Hwy Ste B
North East, MD 21901-2610

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Other practice location 1

774 Christiana Rd Ste 3
Newark, DE 19713-4219
Phone (302) 368-4841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD, DC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190207000469 DE Practitioner - Physical Therapist in Private Practice 7911245584 Reassigns benefits to 1 organization
I20210406001957 MD Practitioner - Physical Therapist in Private Practice 7911245584 Reassigns benefits to 1 organization
I20210407000311 DC Practitioner - Physical Therapist in Private Practice 7911245584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine and Orthopedic SpecialistsGroup PAC ID 6305995325, 4 clinicians
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

1101 Twin C LN
Suite 203
Newark, DE 19713-2159
Phone (302) 633-1280

9815 Main St
Suite 206
Damascus, MD 20872-2099
Phone (301) 253-6761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0004025DEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Orthopedic Specialists Physical Therapist CurrentSince Aug 4, 2025 Accepting new patients
Spine and Orthopedic Specialists Physical Therapist CurrentSince Aug 4, 2025 Accepting new patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Apr 1, 2021 Accepting new patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Apr 1, 2021 Accepting new patients

Locations

119 W 3rd St
Ste 1
Lewes, DE 19958
Phone (302) 291-2587

1101 Twin C Ln
Ste 203
Newark, DE 19713
Phone (302) 633-1280

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

9815 Main St
Ste 206
Damascus, MD 20872
Phone (301) 253-6761

141 Thomas Johnson Dr
Ste 180
Frederick, MD 21702
Phone (301) 620-7478

2540 Pulaski Hwy
#B
North East, MD 21901
Phone (410) 339-1960

25 Main St
Ste A
Reisterstown, MD 21136
Phone (410) 833-8300

Organizations & group practices 4

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": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1407320880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 PULASKI HWY STE B",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219012610",
            "telephone_number": "410-339-1960",
            "fax_number": "443-941-9441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "774 Christiana Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197134219",
            "country_code": "US",
            "telephone_number": "302-368-4841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-18",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0004025",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "28369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North East, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.