Jacqueline Smith, DPT
Individual provider Active NPI Physical Therapist · Corydon, IN
NPI 1831339985 · NPPES record last updated Apr 18, 2019
Key facts
- NPI
- 1831339985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 05009798A (IN)
- Practice address
- 2207 Concord Ave NW Ste 100
Corydon, IN 47112-3097 - Phone
- (812) 738-3616
- Fax
- (812) 738-3619
- NPI assigned
- Mar 3, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 20
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- SN Kentuckiana Rehab, LLC
Practice addresses (Care Compare)
173 Pacer Dr NW
Corydon, IN 47112-2144
Phone (812) 734-1918
325 E Lewis and Clark Pkwy
Suite 100
Clarksville, IN 47129-1725
Phone (812) 283-3231
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090420000377 | IN | Practitioner - Physical Therapist in Private Practice | 0244387769 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05009798A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SN Kentuckiana Rehab, LLC | Current |
Accepting new patients | |
| SN Kentuckiana Rehab, LLC | Current |
Accepting new patients | |
| SN Kentuckiana Rehab, LLC | Current | Accepting new patients |
Locations
9407 County Road 403
Charlestown, IN 47111
Phone (812) 256-0528
325 E Lewis and Clark Pkwy
Ste 100
Clarksville, IN 47129
Phone (812) 283-3231
1730 Williamsburg Dr
Ste 3
Jeffersonvlle, IN 47130
Phone (812) 246-0705
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05009798A | IN | Yes |
Addresses
Primary practice location
2207 Concord Ave NW Ste 100
Corydon, IN 47112-3097
Mailing address
2700 Stanley Gault Pkwy Ste 129
Louisville, KY 40223-5176
Phone (502) 253-4914
Other providers in Corydon, IN
- Veronica Mae Shireman
- Steven M Sieg
- Andrea Skaggs
- Dana L Smallwood
- Kristi Smith-Sallee
- Mary Louise Smith
- Stephanie L Smith
- SN Kentuckiana Rehab, LLC
- Snyder Hearing Center
- Dylan Snyder
All providers in Corydon, IN · Physical Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.