Individual provider Active NPI

Brett I Smith

  • Physical Therapist
  • Nebraska City, NE
National Provider Identifier
1619064300
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1035 Issued in NE
Practice address
1104 Grundman Blvd
Nebraska City, NE 68410-3397
Phone
(402) 873-7411
Fax
(402) 873-7413
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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 1035 NE Primary

Addresses

Primary practice location

1104 Grundman Blvd
Nebraska City, NE 68410-3397

Mailing address

1104 Grundman Blvd
Nebraska City, NE 68410-3397
Phone (402) 873-7411

Other identifiers 2

IdentifierTypeStateIssuer
36520OtherNEBCBS
650016963OtherNERR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060428000235 NE Practitioner - Physical Therapist in Private Practice 1850333618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska City Physical Therapy LLCGroup PAC ID 4486836301, 12 clinicians
Rehabvisions Therapy NE LLCGroup PAC ID 8224378617, 20 clinicians

Practice addresses (Care Compare)

1104 Grundman Blvd
Nebraska City, NE 68410-3397
Phone (402) 873-7411

11623 Arbor St
Omaha, NE 68144-2981
Phone (402) 334-1919

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1035NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabvisions Therapy NE, LLC Physical Therapist CurrentSince Jan 20, 2025 Accepting new patients
Rehabvisions Therapy NE, LLC Physical Therapist CurrentSince Jan 20, 2025 Accepting new patients
Nebraska City Physical Therapy, LLC Physical Therapist CurrentSince Feb 15, 2011 Accepting new patients
Milford Physical Therapy LLC Physical Therapist Current Accepting new patients
Crete Physical Therapy, LLC Physical Therapist Past Accepting new patients

Locations

6319 Havelock Ave
Lincoln, NE 68507
Phone (402) 325-0044

3818 Normal Blvd
Lincoln, NE 68506
Phone (402) 488-4282

511 1st St
Milford, NE 68405
Phone (402) 761-4000

1104 Grundman Blvd
Nebraska City, NE 68410
Phone (402) 873-7411

11623 Arbor St
Omaha, NE 68144
Phone (402) 334-1919

510 Bradford St
Ste B
Seward, NE 68434
Phone (402) 646-2007

Organizations & group practices 5

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1619064300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 GRUNDMAN BLVD",
            "city": "NEBRASKA CITY",
            "state": "NE",
            "postal_code": "684103397",
            "telephone_number": "402-873-7411",
            "fax_number": "402-873-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 GRUNDMAN BLVD",
            "city": "NEBRASKA CITY",
            "state": "NE",
            "postal_code": "684103397",
            "telephone_number": "402-873-7411",
            "fax_number": "402-873-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRETT",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "36520",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "650016963",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nebraska City, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.