Nicole A Smith, M.S.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305204740 Issued in VA

Practice address

572 Garrisonville Rd
Stafford, VA 22554-3702

Phone

(540) 659-6408

NPI assigned

Feb 8, 2007

Last updated

Dec 29, 2014By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Stafford Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Stafford, VA
  • NPI 1114239498
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1710027529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 LOTUS LN",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225546834",
            "telephone_number": "703-600-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 GARRISONVILLE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225543702",
            "telephone_number": "540-659-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICOLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "M.S.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHP BOARD PT LICENSE",
            "identifier": "2305204740",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evelyn Smith, NP
• Felicia Ann Smith, LCSW
• Garrett Paul Smith
• Isabela Danielle Smith
• Jessica Smith
• Patience R Smith, CCC-SLP
• Rachel Smith
• Tichira Smith
• Dawn M Smutz, LPC
• Solid Blu ABA, LLC

• Physical Therapist in Stafford, VA
• Providers in Stafford, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.