Individual provider Active NPI

Kathleen M Smith, DPT

  • Physical Therapist
  • Upper Arlington, OH
National Provider Identifier
1831664416
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017627 Issued in OH
Practice address
4605 Sawmill Rd
Upper Arlington, OH 43220-2246
Phone
(614) 827-8700
Fax
(614) 827-8701
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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 PT017627 OH Primary

Addresses

Primary practice location

4605 Sawmill Rd
Upper Arlington, OH 43220-2246

Mailing address

4605 Sawmill Rd
Upper Arlington, OH 43220-2246
Phone (614) 827-8700

Other names 1

  • Kathleen M Clark Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181108002924 OH Practitioner - Physical Therapist in Private Practice 0042564114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enliven Rehabilitation Services LLCGroup PAC ID 1850626375, 10 clinicians

Practice addresses (Care Compare)

630 Morrison Rd
Suite 310
Gahanna, OH 43230-5318
Phone (614) 755-2347

Merit-based Incentive Payment System (MIPS)

Final score
90.64 of 100Reported as group
Quality
89.85
Promoting interoperability
100
Improvement activities
40
Cost
78.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017627OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic One, Inc CurrentSince Sep 24, 2018 Accepting new patients
Orthopedic One, Inc. CurrentSince Sep 24, 2018 Accepting new patients

Locations

4604 Sawmill Rd
Upper Arlngtn, OH 43220
Phone (614) 839-2300

4605 Sawmill Rd
Upper Arlngtn, OH 43220
Phone (614) 827-1050

Organizations & group practices 3

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": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1831664416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 SAWMILL RD",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432202246",
            "telephone_number": "614-827-8700",
            "fax_number": "614-827-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 SAWMILL RD",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432202246",
            "telephone_number": "614-827-8700",
            "fax_number": "614-827-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT017627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "CLARK",
            "middle_name": "M",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Upper Arlington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.