Amy Marie Smith, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01388200 Issued in NJ

Practice address

12655 W Jefferson Blvd
Los Angeles, CA 90066

Phone

(888) 859-0145

NPI assigned

Mar 22, 2011

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Fairbanks & Power Physical Therapy Corp.

  dba PacificPro Physical Therapy & Sports Medicine

  • Physical Therapist
  • Irvine, CA
  • NPI 1912953936
  Medicare reassignment NPD
• Kulagy Physical Therapy, PC

  dba dba PeteHealth

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1265895080
  Medicare reassignment

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567814400000",
    "number": "1679872287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12655 W JEFFERSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667008",
            "telephone_number": "888-859-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 W JEFFERSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90066",
            "telephone_number": "888-859-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12655 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90066",
            "country_code": "US",
            "telephone_number": "888-859-0145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2019-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01388200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Smith, M.D.
• Alison Paolucci Smith
• Allison Smith
• Amanda Smith
• Amanda Nichole Smith, N.P.
• Anais Smith
• Andrew James Smith, DPT, ATC, CSCS
• Aneesah Smith, M.D.
• Angela Smith
• Angelique Ja-Nean Smith, OTR/L

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2019; 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.