Kimberly M Smith, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

20778 Issued in MD

Practice address

12158 Central Ave
Mitchellville, MD 20721-1932

Phone

(301) 390-3076

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Encompass Health Rehabilitation Hospital of Rock Hill, LLC

  • Rehabilitation Hospital
  • Rock Hill, SC
  • NPI 1184697807
  NPD (past)
• Physical Therapy Center,LLC

  • Physical Therapist
  • Monroe, NC
  • NPI 1053545988
  NPD (past)
• Volk Physical Therapy and Sports Medicine, LLC

  • Physical Therapist
  • Fort Mill, SC
  • NPI 1326122094
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1851475693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12158 CENTRAL AVE STE 113",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207211932",
            "telephone_number": "301-390-3076",
            "fax_number": "301-390-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12158 CENTRAL AVE",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207211932",
            "telephone_number": "301-390-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4779",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Schultheis, OTR/L
• Select Physical Therapy Holdings, Inc.
• Nijeul X. Sharp, OTR
• Folashade Shokunbi
• Amelia Carlene Simmons, PHD, NCC, LGPC
• Shayna Sragg
• Nattasha Srikongyos, DMD, MS
• Amanda Leah Stabile
• Shirley Rose Subryan, ED.D
• T&J Enterprises, Inc.

• All providers in Mitchellville, MD
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.