Kristen Smith, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA004933 Issued in GA

Practice address

3500 Annandale LN
Suwanee, GA 30024-2150

Phone

(678) 765-4811

NPI assigned

Oct 15, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1861212896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 DOLLAR CIR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242359",
            "telephone_number": "470-290-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 ANNANDALE LN",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242150",
            "telephone_number": "678-765-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTEN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA004933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davis Smith, D.M.D.
• Emily Anne Smith, BA, RBT
• Hensel Smith, RBT
• Jennifer Tynette Smith, DPT
• Joel Anthony Smith, PTA
• Shakhirya Satomi Smith
• Tetyana Tsishenko Smith, LMT
• Jovanna Marie Snead, BA
• Kendall Sneed
• David Shane Snyder Sr., RNFA

• Physical Therapy Assistant in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.