Johnny L Smith, M.S.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501001786 Issued in MI

Practice address

23077 Greenfield Rd
Ste 250
Southfield, MI 48075-3709

Phone

(248) 557-7336

Fax

(248) 557-4544

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

No

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

Credentials

Master of Science

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.

• Bodylogic Massage Therapy LLC

  • Massage Therapist
  • Farmington, MI
  • NPI 1023842309
  NPD

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1508935321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD",
            "address_2": "STE 250",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753709",
            "telephone_number": "248-557-7336",
            "fax_number": "248-557-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD",
            "address_2": "STE 250",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753709",
            "telephone_number": "248-557-7336",
            "fax_number": "248-557-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHNNY",
        "middle_name": "L",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501001786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackson Smith, DPT
• Jacqueline Elizabeth Smith, AGPCNP-BC
• Jalisa Smith
• James Bernard Smith Jr., M.D., PH.D.
• Jasma Smith
• Juan Smith
• Katherine Lawson Smith, LMSW
• Kavena Smith, RN
• Kaylie Smith
• Kelly Margaret Smith, LPC LLP

• Physical Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.