Individual provider Active NPI

Michael Smith, PT, DPT, CSCS

  • Physical Therapist
  • Decatur, GA
National Provider Identifier
1891242046
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012594 Issued in GA
Practice address
5255 Snapfinger Park Dr
Decatur, GA 30035-4084
Phone
(770) 322-7003
NPI assigned
Sep 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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 PT012594 GA Primary

Addresses

Primary practice location

5255 Snapfinger Park Dr
Decatur, GA 30035-4084

Mailing address

2916 Clairmont Rd NE
Apt 3203
Brookhaven, GA 30329-4441
Phone (423) 413-9261

Other identifiers 1

IdentifierTypeStateIssuer
PT012594OtherGAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180112000316 GA Practitioner - Physical Therapist in Private Practice 2365701661 Reassigns benefits to 1 organization
I20180821004037 TN Practitioner - Physical Therapist in Private Practice 2365701661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chattanooga Orthopaedic Group, PCGroup PAC ID 1254229156, 75 clinicians

Practice addresses (Care Compare)

2415 McCallie Ave
Chattanooga, TN 37404-3322
Phone (423) 624-2696

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11853TNMDOrthodontics and Dentofacial Orthopedic Dentist
PT012594GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Rehabilitation & Consulting Limited Partnership Physical Therapist CurrentSince Jul 31, 2017 Accepting new patients
Advance Rehabilitation & Consulting Limited Partnership Physical Therapist CurrentSince Jul 31, 2017 Accepting new patients
Chattanooga Orthopaedic Group, PC CurrentSince May 21, 2018 Accepting new patients
Chattanooga Orthopaedic Group PC Physical Therapist CurrentSince May 21, 2018 Accepting new patients

Locations

7423 Adairsville Hwy
Adairsville, GA 30103
Phone (770) 373-9315

1422 Green Rd
Ste N
Chatsworth, GA 30705
Phone (706) 695-9699

1000 Johnson Ferry Rd
Ste A115
Marietta, GA 30068
Phone (404) 367-2085

2415 McCallie Ave
Chattanooga, TN 37404
Phone (423) 629-4395

Interoperability endpoints

  • Direct secure messaging: michael.smith.1@519.direct.athenahealth.com

Organizations & group practices 4

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": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473120000000",
    "number": "1891242046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 CLAIRMONT RD NE",
            "address_2": "APT 3203",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303294441",
            "telephone_number": "423-413-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 SNAPFINGER PARK DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354084",
            "telephone_number": "770-322-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PT012594",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.