Individual provider Active NPI

Michael L. Smith, LPT

  • Physical Therapist
  • Cordova, TN
National Provider Identifier
1700882933
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4691 Issued in TN
Practice address
1650 Bonnie LN
Ste 104
Cordova, TN 38016-0517
Phone
(901) 756-1650
Fax
(901) 756-1396
NPI assigned
Jun 22, 2005
Last updated
Sep 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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 4691 TN Primary

Addresses

Primary practice location

1650 Bonnie LN
Ste 104
Cordova, TN 38016-0517

Mailing address

8110 Cordova Rd
Ste 107
Cordova, TN 38016-0520
Phone (901) 756-1650

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111007000258 TN Practitioner - Physical Therapist in Private Practice 1951203215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Tennessee, HSC, College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Smith Clinic for Physical TherapyGroup PAC ID 1456253715, 3 clinicians

Practice addresses (Care Compare)

8110 Cordova Rd
Cordova, TN 38016-0520

8110 Cordova Rd
Cordova, TN 38016-0521
Phone (901) 756-1650

Merit-based Incentive Payment System (MIPS)

Final score
17.84 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
59.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT3627MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Smith Clinic for Physical Therapy Physical Therapist CurrentSince Apr 17, 2000 Accepting new patients
Baptist Memorial Hospital-Desoto, Inc. Past Accepting new patients
Chattanooga Orthopaedic Group PC Physical Therapist Past Accepting new patients

Locations

7037 Hacks Cross Rd
Olive Branch, MS 38654
Phone (662) 890-2615

1650 Bonnie Ln
Ste 104
Cordova, TN 38016
Phone (901) 756-1650

8110 Cordova Rd
Ste 107
Cordova, TN 38016
Phone (901) 756-1650

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1700882933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 CORDOVA RD",
            "address_2": "STE 107",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160520",
            "telephone_number": "901-756-1650",
            "fax_number": "901-756-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 BONNIE LN",
            "address_2": "STE 104",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160517",
            "telephone_number": "901-756-1650",
            "fax_number": "901-756-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "4691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.