Bradley Olin Smith

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501016438 Issued in MI

Practice address

2625 Plymouth Rd
Ann Arbor, MI 48105-2468

Phone

(810) 231-6904

NPI assigned

Oct 3, 2013

Sex

Male

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

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ethos Physical Therapy LLCGroup PAC ID 6507235298, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ethos Physical Therapy LLC

  • Physical Therapist
  • Plymouth, MI
  • NPI 1225757719
  Medicare reassignment Care Compare group NPD
• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Physical Therapist

  Medicare reassignment NPD
• Ethos Pediatric Therapy LLC

  • Occupational Therapist
  • Plymouth, MI
  • NPI 1629913561
  NPD Authorized official

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1902233000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052468",
            "telephone_number": "810-231-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRADLEY",
        "middle_name": "OLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-03",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Smith
• Anthony Smith
• Autumm Smith
• Autumn Ilene Smith, NP
• Beth Ann Smith, DPT
• Caitlyn O'Neil Smith, PT, DPT
• Caralee Kay Smith, NP
• Cathy Ann Smith, NP
• Chloe Rose Smith, SLP
• Christine Marie Smith, CRNA

• Physical Therapist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.