Vicki A. Smith, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

000693 Issued in KY

Practice address

704 Bloomfield Rd
Bardstown, KY 40004-2025

Phone

(502) 331-5478

Fax

(502) 348-9825

NPI assigned

Jan 12, 2007

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Blanford Pediatric Therapy LLC

  • Social Worker
  • Bardstown, KY
  • NPI 1093220741
  NPD (past)
• Blanford Pediatric Therapy LLC

  • Pediatric Occupational Therapist
  • Bardstown, KY
  • NPI 1508222340

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1508917113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 BLOOMFIELD RD",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042025",
            "telephone_number": "502-331-5478",
            "fax_number": "502-348-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 BLOOMFIELD RD",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042025",
            "telephone_number": "502-331-5478",
            "fax_number": "502-348-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "VICKI",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "000693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100447090",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000001056340",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Jay Smith, CSW
• Emily Brooke Smith, APRN
• Julie Carmen Smith
• Kali C Smith, APRN
• Robert Alan Smith, MD
• Julia Rose Spalding, MHA
• Holly L Sparrow
• Mark D St Peter
• Leeann Abney Starkey, OTR
• Stars and Stripes Medical LLC

• All providers in Bardstown, KY
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.