Victoria Renera-Nisa Smith, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11179 Issued in NC

Practice address

Duke University Health System
4020 North Roxboro St
Durham, NC 27704

Phone

(919) 613-1720

NPI assigned

Jul 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Victoria Lamb Former name

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.

• Ascend Physical Therapy, LLC

  • Physical Therapist
  • Apex, NC
  • NPI 1649745068
  NPD Authorized official
• Living Well PT and Wellness, LLC

  • Physical Therapist
  • Apex, NC
  • NPI 1982253019
  NPD Authorized official
• Ascend Leadership Academy Inc

  • Local Education Agency (LEA)
  • Sanford, NC
  • NPI 1366279325
  NPD

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1861690315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 CELANDINE DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024164",
            "telephone_number": "919-208-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DUKE UNIVERSITY HEALTH SYSTEM",
            "address_2": "4020 NORTH ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27704",
            "telephone_number": "919-613-1720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1102 Celandine Dr",
            "address_purpose": "LOCATION",
            "city": "Apex",
            "state": "NC",
            "postal_code": "275024164",
            "country_code": "US",
            "telephone_number": "919-208-0518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "VICTORIA",
        "middle_name": "RENERA-NISA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NC",
            "license": "11179",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "11179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "068UC",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212247",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "LAMB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shannon Elizabeth Smith, MSW, LCSW
• Stephanie Smith, RN
• Stephen Richard Smith, M.D.
• Tiffany Sheree Smith, CTRS, CARSS1
• Tony Preston Smith, M.D.
• Virginia Lee Nethery Smith
• Vynedra A Smith, M.D.
• William Fleetwood Smith, PA-C
• Elliot Smits, MD
• Kelly Smoke, LCSW-A

• Physical Therapist in Durham, NC
• Providers in Durham, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.