Andrew Smietana, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11094 Issued in CT

Practice address

280 David L Goldfein St
Holloman Afb, NM 88330-8273

Phone

(575) 572-8860

NPI assigned

Jun 3, 2016

Reactivated

Oct 31, 2018

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

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1649629338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 DAVID L GOLDFEIN ST",
            "city": "HOLLOMAN AFB",
            "state": "NM",
            "postal_code": "883308273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 DAVID L GOLDFEIN ST",
            "city": "HOLLOMAN AFB",
            "state": "NM",
            "postal_code": "883308273",
            "telephone_number": "575-572-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIETANA",
        "first_name": "ANDREW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-03",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "deactivation_date": "2018-10-23",
        "reactivation_date": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "11094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shevina Yvette Session, LVN
• Tarek Shabany, D.D.S.
• Kaitlyn M Shaughnessy, DPT
• Jessica Nicole Simmons, PHARMD
• John Francis Skicki, PSY.D.
• Debra Ann Smith, RNC, MS, WHNP
• Ericka Renee Smith, DA 3160
• Ryan Lloyd Smith, PHYSICAL THERAPIST
• Zachary James Smith, PHARM D
• Sayyid Stanford, LCSW

• Physical Therapist in Holloman Afb, NM
• Providers in Holloman Afb, NM by specialty
• Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.