Individual provider Active NPI

Dannie Carroll Smith, PT, ECS

  • Clinical Electrophysiology Physical Therapist
  • Thomaston, GA
National Provider Identifier
1487824918
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Electrophysiology Physical TherapistTaxonomy code 2251E1300X
License
PT000819 Issued in GA
Practice address
42 Dogwood TRL
Thomaston, GA 30286-4911
Phone
(706) 647-6218
Fax
(706) 647-3480
NPI assigned
Mar 12, 2008
Last updated
Mar 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Electrophysiology Physical Therapist 2251E1300X PT000819 GA Primary

Addresses

Primary practice location

42 Dogwood TRL
Thomaston, GA 30286-4911

Mailing address

42 Dogwood TRL
Thomaston, GA 30286-4911
Phone (706) 647-6218

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110321000307 GA Practitioner - Physical Therapist in Private Practice 3375726920 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT000819GAMDClinical Electrophysiology Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Arts Physical Therapy Electrophysiology, Clinical CurrentSince May 5, 2014 Accepting new patients
Macon Orthopaedic & Hand Center, PA CurrentSince Jul 1, 2014 Accepting new patients
Forsyth Street Orthopaedic Surgery and Rehabilitation Center Past Accepting new patients
Dialysis Center of Forsyth LLC Past Accepting new patients

Locations

120 N Lee St
#E
Forsyth, GA 31029
Phone (478) 994-3390

3708 Northside Dr
Macon, GA 31210
Phone (478) 254-5303

301 Margie Dr
Warner Robins, GA 31088
Phone (478) 953-5800

Interoperability endpoints

  • Direct secure messaging: dannie.smith.1@4291.direct.athenahealth.com

Organizations & group practices 5

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": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1487824918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 DOGWOOD TRL",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302864911",
            "telephone_number": "706-647-6218",
            "fax_number": "706-647-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 DOGWOOD TRL",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302864911",
            "telephone_number": "706-647-6218",
            "fax_number": "706-647-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANNIE",
        "middle_name": "CARROLL",
        "name_prefix": "Mr.",
        "credential": "PT, ECS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "GA",
            "license": "PT000819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomaston, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.