Kelly Smoot

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14609 Issued in TN

Practice address

1043 Jack Vest Drive
Johnson City, TN 37614

Phone

(423) 439-4044

NPI assigned

Jul 31, 2023

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Medical Education Assistance Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480
  NPD

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1407537533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 CHARTER ROW",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 JACK VEST DRIVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37614",
            "telephone_number": "423-439-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOOT",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q086331",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Michael Smith, MD
• Wayne O Smith, MD
• Shelley Ann Smithdeal, MS, CCC-SLP
• Smokey Mountain Anesthesia PC
• Smokie Mountain Dialysis Inc.
• Whitney Smotherman
• Timothy Scott Smyth, M.D.
• Reagan Begley Smythe, BSN-RN
• Ashlee P Snapp, FNP-C
• Lauren E Snapp, NP

• Physical Therapist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.