Katie Jo Smith, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9176 Issued in MN

Practice address

6700 France Ave S
Suite 300
Edina, MN 55435-1902

Phone

(952) 345-3000

Fax

(952) 345-6789

NPI assigned

Sep 14, 2012

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 names 1

• Katie Jo Larsen Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optage IncGroup PAC ID 2264619345, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Optage Inc

  • Rehabilitation Clinic/Center
  • Roseville, MN
  • NPI 1801517230

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• National Dizzy & Balance Center,LTD.

  • Physical Medicine & Rehabilitation Physician
  • Bloomington, MN
  • NPI 1023021938

  Physical Therapist

  Medicare reassignment NPD
• Optage Inc

  • Rehabilitation Clinic/Center
  • Saint Paul, MN
  • NPI 1255021366

  Physical Therapist

  NPD
• Optage Inc

  • Rehabilitation Clinic/Center
  • Mahtomedi, MN
  • NPI 1699464149

  Physical Therapist

  NPD

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1447500657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 FRANCE AVE S",
            "address_2": "SUITE 300",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351902",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 FRANCE AVE S",
            "address_2": "SUITE 300",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351902",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATIE",
        "middle_name": "JO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "LARSEN",
            "middle_name": "JO",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher Smith, M.D.
• Cynthia Jane Smith, MD
• Daniel Smith, PT, ATC
• David O. Smith, M.D.
• June Ellen Smith, NP
• Kim Hill Smith, MSW LICSW
• Marissa Smith, LMFT
• Michael D Smith, M.D.
• Rachel Smith
• Susan SM Smith, NURSE PRACTITIONER

• Physical Therapist in Edina, MN
• Providers in Edina, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.