Active NPI
Justin Smith, DPT
- Geriatric Physical Therapist
- Derby, KS
National Provider Identifier
1750087524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 11-06331
- Practice address
- 731 N Klein Cir
Derby, KS 67037-7011 - Phone
- (316) 719-2400
- NPI assigned
- Feb 3, 2023
- Last updated
- Jul 18, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 11-06331 | KS | Primary |
Addresses
Primary practice location
731 N Klein Cir
Derby, KS 67037-7011
Mailing address
731 N Klein Cir
Derby, KS 67037-7011
Phone (316) 719-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11-06331 | Other | KS | KANSAS PHYSICAL THERAPY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11-06331 | KS | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752796800000",
"number": "1750087524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 N KLEIN CIR",
"city": "DERBY",
"state": "KS",
"postal_code": "670377011",
"telephone_number": "316-719-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "731 N KLEIN CIR",
"city": "DERBY",
"state": "KS",
"postal_code": "670377011",
"telephone_number": "316-719-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JUSTIN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-03",
"last_updated": "2025-07-18",
"certification_date": "2025-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "KS",
"license": "11-06331",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KANSAS PHYSICAL THERAPY LICENSE",
"identifier": "11-06331",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Derby, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.