Stacey Marie Smith, M.P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 22447 Issued in CA

Practice address

1502 Montana Ave Ste 207
Santa Monica, CA 90403-1875

Phone

(310) 458-0898

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• S&G Santosha, Inc.

  dba Stacey Smith Physical Therapy

  • Physical Therapist
  • Santa Monica, CA
  • NPI 1235290636
  NPD (past) Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619038007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 MONTANA AVE STE 207",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904031875",
            "telephone_number": "310-458-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 MONTANA AVE STE 207",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904031875",
            "telephone_number": "310-458-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "credential": "M.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 22447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OPT 224470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Narda L. Smith, LMFT, ATR-BC
• Paul Lawrence Smith, MD
• Ralph Smith
• Rhionna Jane Smith, PA-C
• Ronald James Smith, MD
• Tamara Renee Smith, ND
• Tracy Smith
• Yramnna Smith, PSYD, LMFT, BCBA
• Susan Lake Sneed
• Linda Goodwin Snouffer, LCSW, CEAP

• Physical Therapist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Physical Therapist in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.