Individual provider Active NPI

Lynda Goldsmith, P.T.

  • Physical Therapist
  • Gurnee, IL
National Provider Identifier
1700934866
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1800 Nations Dr Ste 101
Gurnee, IL 60031-9169
Phone
(847) 263-0480
Fax
(847) 263-0590
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

1800 Nations Dr Ste 101
Gurnee, IL 60031-9169

Mailing address

1800 Nations Dr Ste 101
Gurnee, IL 60031-9169
Phone (847) 263-0480

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170331001150 WA Practitioner - Physical Therapist in Private Practice 9032179486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14751 Bel Red Rd
Suite 100
Bellevue, WA 98007

14951 Bel Red Rd
Suite 100
Bellevue, WA 98007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070007643ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Physical Therapy Physical Therapist Past Accepting new patients
Lake Zurich Physical Medicine, SC Past Accepting new patients
North Suburban Medical S.C. PastSince Aug 30, 2004 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700934866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NATIONS DR STE 101",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319169",
            "telephone_number": "847-263-0480",
            "fax_number": "847-263-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NATIONS DR STE 101",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319169",
            "telephone_number": "847-263-0480",
            "fax_number": "847-263-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSMITH",
        "first_name": "LYNDA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.