Individual provider Active NPI

David Paul Smelser, PT, DPT

  • Physical Therapist
  • Roswell, GA
National Provider Identifier
1720535487
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012611 Issued in GA
Practice address
930 Woodstock Rd
Suite 310
Roswell, GA 30075-2220
Phone
(770) 998-6636
Fax
(770) 998-6646
NPI assigned
Sep 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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 PT012611 GA Primary

Addresses

Primary practice location

930 Woodstock Rd
Suite 310
Roswell, GA 30075-2220

Mailing address

930 Woodstock Rd
Suite 310
Roswell, GA 30075-2220
Phone (770) 998-6636

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161011003098 GA Practitioner - Physical Therapist in Private Practice 4486942216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pro Performance Therapy, LLCGroup PAC ID 2466559828, 4 clinicians

Practice addresses (Care Compare)

4343 Shallowford Rd
Suite G3
Marietta, GA 30062-5021
Phone (770) 449-5152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Performance Therapy, LLC Physical Therapist CurrentSince Mar 1, 2021 Accepting new patients

Locations

4343 Shallowford Rd
Ste G3
Marietta, GA 30062
Phone (770) 449-5152

4343 Shallowford Rd
Ste G3
Marietta, GA 30062
Phone (678) 626-7207

4343 Shallowford Rd
Ste 630
Marietta, GA 30062
Phone (770) 449-5152

Organizations & group practices 1

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": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1720535487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 WOODSTOCK RD",
            "address_2": "SUITE 310",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752220",
            "telephone_number": "770-998-6636",
            "fax_number": "770-998-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 WOODSTOCK RD",
            "address_2": "SUITE 310",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752220",
            "telephone_number": "770-998-6636",
            "fax_number": "770-998-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMELSER",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-09",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; 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.