Individual provider Active NPI

Aubrey Smith, DPT

  • Physical Therapist
  • Little Rock, AR
National Provider Identifier
1568915973
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4183 Issued in AR
Practice address
10014 N Rodney Parham Rd
Suite 103
Little Rock, AR 72227-5598
Phone
(501) 224-5454
Fax
(501) 224-5460
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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 4183 AR Primary

Addresses

Primary practice location

10014 N Rodney Parham Rd
Suite 103
Little Rock, AR 72227-5598

Mailing address

10014 N Rodney Parham Rd
Suite 103
Little Rock, AR 72227-5598
Phone (501) 224-5454

Other identifiers 1

IdentifierTypeStateIssuer
4183OtherARPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200326001372 TX Practitioner - Physical Therapist in Private Practice 2668760976 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4183ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Compleo Physical Therapy & Wellness LLC Physical Therapist CurrentSince Dec 5, 2023 Accepting new patients

Locations

6704 Woodway Dr
Woodway, TX 76712
Phone (254) 366-3662

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1568915973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10014 N RODNEY PARHAM RD",
            "address_2": "SUITE 103",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722275598",
            "telephone_number": "501-224-5454",
            "fax_number": "501-224-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10014 N RODNEY PARHAM RD",
            "address_2": "SUITE 103",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722275598",
            "telephone_number": "501-224-5454",
            "fax_number": "501-224-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AUBREY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "4183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "4183",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.