NPIMap

Organization Active NPI

The Smith Clinic for Physical Therapy

  • Physical Therapist
  • Cordova, TN
National Provider Identifier
1902823453
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4691 Issued in TN
Legal business name
THE SMITH CLINIC FOR PHYSICAL THERAPY
Practice address
8110 Cordova Rd Ste 107
Cordova, TN 38016-0521
Phone
(901) 756-1650
Fax
(901) 756-1396
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Michael L. Smith, PTNPI 1700882933
Title
Owner/Manager
Phone
(901) 756-1650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 4691 TN Primary

Addresses

Primary practice location

8110 Cordova Rd Ste 107
Cordova, TN 38016-0521

Mailing address

8110 Cordova Rd Ste 107
Cordova, TN 38016-0521
Phone (901) 756-1650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060725000232 TN Part B Supplier - Clinic/Group Practice 1456253715 Receives reassigned benefits from 6 practitioners
Practice locations: Cordova, TN

National Provider Directory

National Provider Directory

Locations

7037 Hacks Cross Rd
Olive Branch, MS 38654
Phone (662) 890-2615

8110 Cordova Rd
Ste 107
Cordova, TN 38016
Phone (901) 756-1650

1650 Bonnie Ln
Ste 104
Cordova, TN 38016
Phone (901) 756-1650

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1902823453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 CORDOVA RD STE 107",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160521",
            "telephone_number": "901-756-1650",
            "fax_number": "901-756-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 CORDOVA RD STE 107",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160521",
            "telephone_number": "901-756-1650",
            "fax_number": "901-756-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SMITH CLINIC FOR PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "901-756-1650",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "4691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.