Jessica Smith, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

111 Penn St
El Segundo, CA 90245-3908

Phone

(310) 426-9570

NPI assigned

Oct 2, 2017

Last updated

Oct 2, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rehabsuite Inc

  • Physical Therapist
  • Prescott, AZ
  • NPI 1184319154
  Medicare reassignment NPD
• Tag Physical Therapy, Inc

  • Physical Therapist
  • El Segundo, CA
  • NPI 1063581965
  NPD (past)

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506902400000",
    "number": "1679083851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 LYNDON ST APT 1",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PENN ST",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453908",
            "telephone_number": "310-426-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Smith
• Hadassah Smith
• Jada Jelisa Smith
• Jalen Smith
• Jamila Smith
• Joshua Smith, BCBA
• Katherine Smith
• Kaylah Smith
• Meredith Burneal Smith, PHD CLINICAL PSYCH
• Michelle Smith

• Physical Therapist in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.