Individual provider Active NPI

Brittany Smith

  • Physical Therapist
  • Dearborn Heights, MI
National Provider Identifier
1588939508
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016361 Issued in MI
Practice address
23541 Hanover St
Dearborn Heights, MI 48125-2342
Phone
(419) 615-8863
NPI assigned
Mar 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 13414 OH
Physical Therapist 225100000X 5501016361 MI Primary

Addresses

Primary practice location

23541 Hanover St
Dearborn Heights, MI 48125-2342

Mailing address

23541 Hanover St
Dearborn Heights, MI 48125-2342
Phone (419) 615-8863

Other practice location 1

324 N Main St
Suite 300
Minster, OH 45865-9560
Phone (419) 628-6920

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5501016361MIMDPhysical Therapist
PT 13414OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1588939508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23541 HANOVER ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481252342",
            "telephone_number": "419-615-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23541 HANOVER ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481252342",
            "telephone_number": "419-615-8863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 N Main St",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Minster",
            "state": "OH",
            "postal_code": "458659560",
            "country_code": "US",
            "telephone_number": "419-628-6920",
            "fax_number": "419-628-8028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT 13414",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.