Individual provider Active NPI

Randy Smith, DPT

  • Physical Therapist
  • Middletown, DE
National Provider Identifier
1417268111
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0002626 Issued in DE
Practice address
5360 Summit Bridge Rd Ste 6
Middletown, DE 19709-4806
Phone
(302) 342-8451
NPI assigned
Jun 28, 2010
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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 PT020577 PA
Physical Therapist 225100000X J1-0002626 DE Primary

Addresses

Primary practice location

5360 Summit Bridge Rd Ste 6
Middletown, DE 19709-4806

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

1288 S Governors Ave
Dover, DE 19904-4802
Phone (302) 793-0432

Other identifiers 2

IdentifierTypeStateIssuer
1417268111MedicaidDE
P01300282OtherDERAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110324000501 DE Practitioner - Physical Therapist in Private Practice 3971786211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Physical Therapy of Delaware LLCGroup PAC ID 4284964669, 22 clinicians

Practice addresses (Care Compare)

30166 Commerce Dr
Millsboro, DE 19966-3585
Phone (302) 663-9890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT020577PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Delaware LLC Physical Therapist CurrentSince Jan 17, 2025 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

5360 Summit Bridge Rd
Ste 6
Middletown, DE 19709
Phone (302) 342-8451

30166 Commerce Dr
Millsboro, DE 19966
Phone (302) 663-9890

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1417268111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5360 SUMMIT BRIDGE RD STE 6",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197094806",
            "telephone_number": "302-342-8451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1288 S Governors Ave",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199044802",
            "country_code": "US",
            "telephone_number": "302-793-0432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RANDY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT020577",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0002626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417268111",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01300282",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.