Individual provider Active NPI

Donna Smith, PT

  • Pediatric Physical Therapist
  • Austin, TX
National Provider Identifier
1558378174
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
1091072 Issued in TX
Practice address
9101 Burnet Rd Ste 103
Austin, TX 78758-5260
Phone
(512) 248-2422
Fax
(512) 248-2354
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 1091072 TX Primary

Addresses

Primary practice location

9101 Burnet Rd Ste 103
Austin, TX 78758-5260

Mailing address

PO Box 270262
Austin, TX 78727-0262
Phone (512) 248-2422

Other identifiers 2

IdentifierTypeStateIssuer
172915401MedicaidTX
8T4435OtherTXBLUE CROSS & BLUE SHIELD

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
1091072TXMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Tesoros Therapy Services, LLP Current Accepting new patients
Little Tesoros Therapy Services, L.L.P. Pediatrics Current Accepting new patients

Locations

9101 Burnet Rd
Ste 103
Austin, TX 78758
Phone (512) 248-2248

1301 Medical Pkwy
Ste 130
Cedar Park, TX 78613
Phone (512) 248-2422

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1558378174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270262",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787270262",
            "telephone_number": "512-248-2422",
            "fax_number": "512-248-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 BURNET RD STE 103",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585260",
            "telephone_number": "512-248-2422",
            "fax_number": "512-248-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DONNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TX",
            "license": "1091072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172915401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "8T4435",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.