Individual provider Active NPI

Matthew J. Smartt, PT

  • Physical Therapist
  • Lake Mary, FL
National Provider Identifier
1811917743
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 11080 Issued in FL
Practice address
150 Middle St
Lake Mary, FL 32746-3408
Phone
(407) 585-1210
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT 11080 FL Primary

Addresses

Primary practice location

150 Middle St
Lake Mary, FL 32746-3408

Mailing address

11500 SW Olmstead Dr
Port St Lucie, FL 34987-1946
Phone (772) 215-8747

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
PT 11080FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811917743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 SW OLMSTEAD DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349871946",
            "telephone_number": "772-215-8747",
            "fax_number": "772-345-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MIDDLE ST",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463408",
            "telephone_number": "407-585-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMARTT",
        "first_name": "MATTHEW",
        "middle_name": "J.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 11080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.