Individual provider Active NPI

Jay Arthur Smith, P.T.

  • Physical Therapist
  • Mount Vernon, WA
National Provider Identifier
1518957489
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00002050 Issued in WA
Practice address
2226 Market St
Ste C
Mount Vernon, WA 98273-5451
Phone
(360) 428-6677
Fax
(360) 428-7635
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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 PT00002050 WA Primary

Addresses

Primary practice location

2226 Market St
Ste C
Mount Vernon, WA 98273-5451

Mailing address

PO Box 1789
Mount Vernon, WA 98273-1789
Phone (360) 428-6677

Other identifiers 1

IdentifierTypeStateIssuer
8343816MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090218000203 WA Practitioner - Physical Therapist in Private Practice 8123910270 Reassigns benefits to 1 organization
Practice locations: Mount Vernon, WA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blanchard Mountain Physical Therapy PLLCGroup PAC ID 5890232441, 3 clinicians

Practice addresses (Care Compare)

2226 Market St
Suite C
Mount Vernon, WA 98273-5451
Phone (360) 840-2472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Blanchard Mountain Physical Therapy PLLC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients

Locations

2226 Market St
Ste C
Mount Vernon, WA 98273
Phone (360) 428-6677

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1518957489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1789",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982731789",
            "telephone_number": "360-428-6677",
            "fax_number": "360-428-7635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 MARKET ST",
            "address_2": "STE C",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735451",
            "telephone_number": "360-428-6677",
            "fax_number": "360-428-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JAY",
        "middle_name": "ARTHUR",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8343816",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.