Individual provider Active NPI

Michelle Preston-Smith, P.T., D.P.T.

  • Physical Therapist
  • Merced, CA
National Provider Identifier
1821013897
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT15272 Issued in CA
Practice address
3184 Collins Dr
Merced, CA 95348-3132
Phone
(209) 230-5289
Fax
(209) 222-6185
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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 PT15272 CA Primary

Addresses

Primary practice location

3184 Collins Dr
Merced, CA 95348-3132

Mailing address

1518 Coffee Rd Ste I
Modesto, CA 95355-3164
Phone (209) 576-0888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111209000455 CA Practitioner - Physical Therapist in Private Practice 3779758388 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT15272CAMDPhysical Therapist
15272CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Sep 11, 2017 Accepting new patients
Gold Country Therapies, Inc PastSince Jan 1, 2015 Accepting new patients

Locations

1229 Commerce Ave
Atwater, CA 95301
Phone (209) 683-1386

3184 Collins Dr
Merced, CA 95348
Phone (209) 230-5289

1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946

1518 Coffee Rd
Ste I
Modesto, CA 95355

1222 W Colony Rd
Ste 130
Ripon, CA 95366
Phone (209) 624-1288

1906 Vista del Lago Dr
Ste A
Valley Springs, CA 95252
Phone (209) 772-0848

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1821013897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 COFFEE RD STE I",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553164",
            "telephone_number": "209-576-0888",
            "fax_number": "209-576-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3184 COLLINS DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483132",
            "telephone_number": "209-230-5289",
            "fax_number": "209-222-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON-SMITH",
        "first_name": "MICHELLE",
        "credential": "P.T.,  D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT15272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.