Tina Nicole Smith, PTA, LMT, NCTMB

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

23837 Issued in AL

Practice address

505 Briarwood Dr
L8
Enterprise, AL 36330-5029

Phone

(344) 255-7169

Fax

(334) 255-7173

NPI assigned

Feb 5, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Nikki Smith Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1538347323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 BRIARWOOD DR",
            "address_2": "L8",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363305029",
            "telephone_number": "334-341-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BRIARWOOD DR",
            "address_2": "L8",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363305029",
            "telephone_number": "344-255-7169",
            "fax_number": "334-255-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TINA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PTA, LMT, NCTMB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AL",
            "license": "23837",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "33.010538",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKKI",
            "last_name": "SMITH",
            "prefix": "MRS.",
            "credential": "PTA, LMT, NCTMB",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brandon Skinner, CRNP
• Aimee Michelle Sklenicka
• Sierra Don Slay, LCSW
• Starla Renea Slay, CRNP
• Anna Jane Brown Smith, FNP-C
• Mallory Elizabeth Smithart
• Southeast Alabama Autism Center
• Southeast Alabama Homecare, LLC
• Southeast Alabama Rural Health Associates
• Southeast Cancer Care Network LLC

• Physical Therapy Assistant in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Physical Therapy Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.