Active NPI
Katie Lynn Smedstad, DPT
- Physical Therapist
- Duluth, MN
National Provider Identifier
1891353389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11692
- Practice address
- 1029 W Central Entrance
Duluth, MN 55811-5477 - Phone
- (952) 835-4512
- Fax
- (888) 425-0398
- NPI assigned
- May 30, 2019
- Sex
- Female
- 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 | 11692 | MN | Primary |
Addresses
Primary practice location
1029 W Central Entrance
Duluth, MN 55811-5477
Mailing address
SSB-6
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107248 | Other | MN | OPTUM (UNITED HEALTH CARE) PROVIDER ID |
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 |
|---|---|---|---|
| 11692 | MN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728777600000",
"number": "1891353389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "SSB-6",
"address_2": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-8364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1029 W CENTRAL ENTRANCE",
"city": "DULUTH",
"state": "MN",
"postal_code": "558115477",
"telephone_number": "952-835-4512",
"fax_number": "888-425-0398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMEDSTAD",
"first_name": "KATIE",
"middle_name": "LYNN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-30",
"last_updated": "2024-10-13",
"certification_date": "2024-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "11692",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUM (UNITED HEALTH CARE) PROVIDER ID",
"identifier": "107248",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
- Lindsay Smart
- Shelly L Smart, MSW, LICSW
- SMDC Medical Center (Essentia Health Duluth)
- SMDC Medical Center (Essentia Health Duluth-Amberwing Clinic)
- SMDC Medical Center (Essentia Health Duluth (Rehab Unit))
- Gail Elizabeth Smith Hendrickson, RN
- Bruce Robert Smith, MD
- Emma Elaina Smith
- Gabriela Bowers Smith, LICSW
- Grace Elizabeth Smith, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.