Individual provider Active NPI

Philip Walter Smith, P.T.

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1598765976
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19300 Issued in FL
Practice address
3670 Henderson Blvd
Suite a
Tampa, FL 33609-4515
Phone
(813) 877-6664
Fax
(813) 877-8799
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 19300 FL Primary

Addresses

Primary practice location

3670 Henderson Blvd
Suite a
Tampa, FL 33609-4515

Mailing address

3670 Henderson Blvd
Suite a
Tampa, FL 33609-4515
Phone (813) 877-6664

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070402000194 FL Practitioner - Physical Therapist in Private Practice 3971607995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Florida Orthopedic Rehabilitation, Inc.Group PAC ID 9931184702, 2 clinicians

Practice addresses (Care Compare)

3670 A Henderson Blvd
Tampa, FL 33609-4515

3670 Henderson Blvd
Suite a
Tampa, FL 33609-4515

3670 Henderson Blvd a
Tampa, FL 33609-4515
Phone (813) 877-6664

3842 W Humphrey St
Tampa, FL 33614-1955
Phone (813) 935-8355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19300FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
West Florida Orthopedic Rehabilitation, Inc. Physical Therapist CurrentSince Jan 1, 2021 Accepting new patients

Locations

3670 Henderson Blvd
Ste A
Tampa, FL 33609
Phone (813) 258-8020

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598765976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3670 HENDERSON BLVD",
            "address_2": "SUITE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094515",
            "telephone_number": "813-877-6664",
            "fax_number": "813-877-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 HENDERSON BLVD",
            "address_2": "SUITE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094515",
            "telephone_number": "813-877-6664",
            "fax_number": "813-877-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PHILIP",
        "middle_name": "WALTER",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "19300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.