Stanley Smith, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13902-24 Issued in WI

Practice address

2345 Canterbury LN
Sister Bay, WI 54234-5602

Phone

(920) 854-4111

NPI assigned

Jan 8, 2007

Last updated

May 5, 2025By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Door County Memorial Hospital

  dba DirectCare

  • Rural Health Clinic/Center
  • Sturgeon Bay, WI
  • NPI 1326748104
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1609925056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S 18TH AVE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542351401",
            "telephone_number": "920-854-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 CANTERBURY LN",
            "city": "SISTER BAY",
            "state": "WI",
            "postal_code": "542345602",
            "telephone_number": "920-854-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STANLEY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13902-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol A Shabbit, OTR
• Shopko Stores Operating Co LLC (Shopko Pharmacy 616)
• Sister Bay Hometown Pharmacy LLC (Sister Bay Hometown Pharmacy)
• Sister Bay Pharmacy
• Sister Bay SNF Opco LLC
• Michael David Stubenvoll, PHARMD
• Holly Ann Swain, PA-C
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Scandia Village)
• James R Thomas, R.PH
• Timothy D. Tishler, D.D.S.

• Physical Therapist in Sister Bay, WI
• Providers in Sister Bay, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.