Kevin C Smith, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01818100 Issued in NJ

Practice address

530 Kinderkamack Rd
River Edge, NJ 07661-2140

Phone

(201) 523-9207

Fax

(201) 523-9208

NPI assigned

Oct 16, 2018

Last updated

Oct 16, 2018By the provider in NPPES

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

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Group practices

K2 Physical Therapy LLCGroup PAC ID 7618340357, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• K2 Physical Therapy LLC

  • Physical Therapist
  • Ho Ho Kus, NJ
  • NPI 1104535673
  Medicare reassignment Care Compare group NPD
• Mile High Physical Therapy Professional Corporation

  • Physical Therapist
  • Pine Brook, NJ
  • NPI 1730665662
  Medicare reassignment NPD

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1558837732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 KINDERKAMACK RD",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076612140",
            "telephone_number": "201-523-9207",
            "fax_number": "201-523-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01818100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tosal Saxena, FNP-BC
• Allen A Schachter, DDS
• Theresa A Schulze, NURSE PRACTITIONER
• Sharyn Zisa Mays LCSW
• Dongwuk Shin, M.D.
• Jodie Sorkenn
• Joseph A Spinapolice, D.O.
• Sara Spoelstra, M.S. CCC-SLP
• Sports Foot and Ankle Center PC
• Taylor Strothmann, LAC

• Physical Therapist in River Edge, NJ
• Providers in River Edge, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.