Individual provider Active NPI

Zoe Lea Smith, PT

  • Physical Therapist
  • Toccoa, GA
National Provider Identifier
1497911580
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009342 Issued in GA
Practice address
348 Big a Rd
Toccoa, GA 30577-6003
Phone
(770) 207-6390
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT009342 GA Primary

Addresses

Primary practice location

348 Big a Rd
Toccoa, GA 30577-6003

Mailing address

1071 Thomas Ave
Watkinsville, GA 30677-6073
Phone (770) 207-6390

Other practice location 1

1949 Highway 81 Ste 100
Loganville, GA 30052-4583
Phone (770) 207-6390

Other practice location 2

1071 Thomas Ave
Watkinsville, GA 30677-6073
Phone (770) 207-6390

Other identifiers 1

IdentifierTypeStateIssuer
925273895BMedicaidGA

Other names 1

  • Zoe Lea Walls Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT009342GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sugarbear Pediatrics, LLC Physical Therapist Current Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1497911580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1071 THOMAS AVE",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306776073",
            "telephone_number": "770-207-6390",
            "fax_number": "678-374-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 BIG A RD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776003",
            "telephone_number": "770-207-6390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1949 Highway 81 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Loganville",
            "state": "GA",
            "postal_code": "300524583",
            "country_code": "US",
            "telephone_number": "770-207-6390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1071 Thomas Ave",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306776073",
            "country_code": "US",
            "telephone_number": "770-207-6390",
            "fax_number": "678-374-4855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ZOE",
        "middle_name": "LEA",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "925273895B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZOE",
            "last_name": "WALLS",
            "middle_name": "LEA",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Toccoa, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.