Kathleen Smith

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11771 Issued in AZ

Practice address

1309 W Guadalupe Rd
Suite 1
Mesa, AZ 85202-9112

Phone

(480) 280-9625

NPI assigned

Aug 18, 2015

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

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.

• Larson Endeavors PLLC

  • Physical Therapy Clinic/Center
  • Mesa, AZ
  • NPI 1760728695
  NPD (past)

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1417323064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 E DESERT LN",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852095206",
            "telephone_number": "480-280-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 W GUADALUPE RD",
            "address_2": "SUITE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029112",
            "telephone_number": "480-280-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy L Smith, CPHT
• Jessica Lynn Smith, M.A. CCC-SLP
• John Smith
• Justin Mark Smith, PSYD
• Katharine Anne Smith, CRNA
• Kelsey Morgan Smith, M OTR/L
• Kendal Smith, MD
• Keona E Smith, NURSE PRACTITIONER
• Larisa R Smith, D.M.D.
• Marvin Smith

• Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.