Individual provider Active NPI

Beryl Ann Smith, P.T.

  • Orthopedic Physical Therapist
  • Dayton, OH
National Provider Identifier
1558332122
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT-10782 Issued in OH
Practice address
1 Childrens Plaza
Orthopaedic Center for Spinal & Pediatric Care
Dayton, OH 45404-1815
Phone
(937) 641-3010
Fax
(937) 641-5003
NPI assigned
Jan 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-10782 OH
Physical Therapist 225100000X 2896324 TN
Pediatric Physical Therapist 2251P0200X PT-10782 OH
Pediatric Physical Therapist 2251P0200X 2896324 TN
Orthopedic Physical Therapist 2251X0800X PT-10782 OH Primary
Orthopedic Physical Therapist 2251X0800X 2896324 TN

Addresses

Primary practice location

1 Childrens Plaza
Orthopaedic Center for Spinal & Pediatric Care
Dayton, OH 45404-1815

Mailing address

2031 Vienna Pkwy
Dayton, OH 45459-1356
Phone (937) 439-1868

Other identifiers 3

IdentifierTypeStateIssuer
2487492MedicaidOH
2487492OtherOHBCMH
00000330619OtherOHANTHEM BCBS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-10782OHMDOrthopedic Physical Therapist
2896324TNMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Physical Therapy & Reh Physical Therapist Past Accepting new patients
Dayton Children'S Orthopaedic Center for Spinal & Pediatric Care, LLC Past Accepting new patients

Organizations & group practices 2

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1558332122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 VIENNA PKWY",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454591356",
            "telephone_number": "937-439-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLAZA",
            "address_2": "ORTHOPAEDIC CENTER FOR SPINAL & PEDIATRIC CARE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041815",
            "telephone_number": "937-641-3010",
            "fax_number": "937-641-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BERYL",
        "middle_name": "ANN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT-10782",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "2896324",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "OH",
            "license": "PT-10782",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TN",
            "license": "2896324",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OH",
            "license": "PT-10782",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TN",
            "license": "2896324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2487492",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "2487492",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "00000330619",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.