Individual provider Active NPI

Cassie Elizabeth Smith, PTA

  • Physical Therapy Assistant
  • Port Arthur, TX
National Provider Identifier
1760159511
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2162538 Issued in UT
Practice address
6767 9TH Ave
Port Arthur, TX 77642-6414
Phone
(409) 722-1485
Fax
(409) 722-1564
NPI assigned
Aug 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2162538 UT Primary

Addresses

Primary practice location

6767 9TH Ave
Port Arthur, TX 77642-6414

Mailing address

6767 9TH Ave
Port Arthur, TX 77642-6414
Phone (409) 722-1485

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

LicenseStateTypeSpecialty
2162538UTMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South County Physical Therapy & Rehabilitation Center, Inc. CurrentSince Aug 29, 2021 Accepting new patients

Locations

6767 9th Ave
Port Arthur, TX 77642
Phone (409) 722-1485

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": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1760159511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 9TH AVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776426414",
            "telephone_number": "409-722-1485",
            "fax_number": "409-722-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 9TH AVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776426414",
            "telephone_number": "409-722-1485",
            "fax_number": "409-722-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CASSIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "UT",
            "license": "2162538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.