Active NPI
Roy M Smith, PT
- Physical Therapist
- Charlotte, NC
National Provider Identifier
1861409260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3108
- Practice address
- 1408 East Blvd
B#2
Charlotte, NC 28203-6103 - Phone
- (704) 355-8100
- Fax
- (704) 355-8127
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3108 | NC | Primary |
Addresses
Primary practice location
1408 East Blvd
B#2
Charlotte, NC 28203-6103
Mailing address
1100 Blythe Blvd
Charlotte, NC 28203-5814
Phone (704) 355-4370
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07924 | Other | NC | BCBS |
| 110441 | Other | NC | WELLNESS |
| 294088 | Other | NC | MAMSI |
| 88728 | Other | NC | MEDCOST |
| 7211859 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3108 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Physicians Network Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1437038544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861409260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035814",
"telephone_number": "704-355-4370",
"fax_number": "704-355-4231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1408 EAST BLVD",
"address_2": "B#2",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282036103",
"telephone_number": "704-355-8100",
"fax_number": "704-355-8127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ROY",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "3108",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "07924",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLNESS",
"identifier": "110441",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "294088",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "88728",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7211859",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.