Kenneth O Smith Jr., DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1234566 Issued in TX

Practice address

1026 W 2ND Ave
Corsicana, TX 75110-3702

Phone

(903) 874-7433

Fax

(903) 874-6295

NPI assigned

Aug 15, 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 LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Texas Tech University Health Science Center School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedic Clinic of MonroeGroup PAC ID 0840252698, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Orthopaedic Clinic of Monroe

  dba North Louisiana Orthopaedic and Sports Medicine Clinic

  • Orthopaedic Surgery Physician
  • Monroe, LA
  • NPI 1144266511
  Medicare reassignment Care Compare group NPD
• Orthopaedic Clinic of Monroe

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West Monroe, LA
  • NPI 1003337478
  NPD

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1902239791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1241",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751511241",
            "telephone_number": "903-874-7433",
            "fax_number": "903-874-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 W 2ND AVE",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751103702",
            "telephone_number": "903-874-7433",
            "fax_number": "903-874-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KENNETH",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1234566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Nicole Smith, COTA
• Bette Ann Smith, SLP
• Debra Kay Smith, PHD
• Jerry Dee Smith, M.D.
• John William Smith, D.D.S.
• South Limestone Hospital District (Avir at Corsicana)
• Southwest Care Associates LP (Mel Haven Convalescent Home)
• Southwest LTC - Corsicana LLC (The Village at Heritage Oaks)
• Southwest LTC - Corsicana West LLC (Legacy West Rehabilitation and Healthcare)
• Michelle Spears, M.D.

• Physical Therapist in Corsicana, TX
• Providers in Corsicana, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.