Individual provider Active NPI

David S Smith, PHYSICAL THERAPIST

  • Physical Therapist
  • Little Rock, AR
National Provider Identifier
1811055643
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2244 Issued in AR
Practice address
800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone
(501) 404-8007
Fax
(501) 904-3620
NPI assigned
Dec 5, 2006
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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 PT2244 AR Primary

Addresses

Primary practice location

800 Fair Park Blvd
Little Rock, AR 72204-1720

Mailing address

800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone (501) 404-8007

Other identifiers 1

IdentifierTypeStateIssuer
5 U462OtherARBCBS PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040608001123 AR Practitioner - Physical Therapist in Private Practice 2264415629 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoarkansas, PA Specialist CurrentSince Jun 12, 2023 Accepting new patients
Tri-Lakes Physical Therapy, Inc. PastSince Oct 1, 2003 Accepting new patients

Locations

353 Cash Rd SW
Camden, AR 71701
Phone (870) 836-8101

800 Fair Park Blvd
Little Rock, AR 72204
Phone (501) 404-8007

Interoperability endpoints

  • Direct secure messaging: david.smith.1@1376.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1811055643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-404-8007",
            "fax_number": "501-904-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-404-8007",
            "fax_number": "501-904-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT2244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "5 U462",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.