Active NPI
Justin Smith, JUSTIN SMITH PT, DPT
- Physical Therapist
- Elizabethton, TN
National Provider Identifier
1598849648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7663
- Practice address
- 629 W Elk Ave
Elizabethton, TN 37643-2559 - Phone
- (423) 543-0073
- Fax
- (423) 543-1277
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7663 | TN | Primary |
Addresses
Primary practice location
629 W Elk Ave
Elizabethton, TN 37643-2559
Mailing address
109 Donna Ave
Elizabethton, TN 37643-2818
Phone (423) 335-4210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1975 W Elk Ave
Suite 1
Elizabethton, TN 37643-3787
Phone (423) 543-0073
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7663 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Services, P.a. | Physical Therapist | Current | Accepting new patients |
Locations
629 W Elk Ave
Elizabethton, TN 37643
Phone (423) 543-0073
1975 W Elk Ave
Ste 1
Elizabethton, TN 37643
Phone (423) 543-0073
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": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598849648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 DONNA AVE",
"city": "ELIZABETHTON",
"state": "TN",
"postal_code": "376432818",
"telephone_number": "423-335-4210",
"fax_number": "423-543-1277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "629 W ELK AVE",
"city": "ELIZABETHTON",
"state": "TN",
"postal_code": "376432559",
"telephone_number": "423-543-0073",
"fax_number": "423-543-1277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JUSTIN",
"name_prefix": "Dr.",
"credential": "JUSTIN SMITH PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "7663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elizabethton, TN
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.