Individual provider Active NPI

Harold Smith

  • Physical Therapy Assistant
  • Fayetteville, NC
National Provider Identifier
1679883342
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
3653 Issued in NC
Practice address
1700 Pamalee Dr
Fayetteville, NC 28301
Phone
(910) 488-2295
NPI assigned
Oct 15, 2010
Last updated
Oct 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 3653 NC Primary

Addresses

Primary practice location

1700 Pamalee Dr
Fayetteville, NC 28301

Mailing address

1700 Pamalee Dr
Fayetteville, NC 28301-2824
Phone (910) 488-2295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3653NCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1679883342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 PAMALEE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283012824",
            "telephone_number": "910-488-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PAMALEE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28301",
            "telephone_number": "910-488-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HAROLD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "3653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.