Individual provider Active NPI

Jennifer Leigh Smith, PT

  • Physical Therapy Assistant
  • Kailua Kona, HI
National Provider Identifier
1912918137
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PT-3910 Issued in HI
Practice address
73-5590 Kauhola St Ste a
Kailua Kona, HI 96740-2610
Phone
(808) 329-7744
Fax
(808) 334-1608
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 5501011256 MI
Physical Therapy Assistant 225200000X PT-3910 HI Primary

Addresses

Primary practice location

73-5590 Kauhola St Ste a
Kailua Kona, HI 96740-2610

Mailing address

73-5590 Kauhola St Ste a
Kailua Kona, HI 96740-2610
Phone (808) 329-7744

Other practice location 1

6563 W Main St
lower level
Kalamazoo, MI 49009-4051
Phone (269) 372-8483

Other names 1

  • Jennifer Smith Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220421001561 HI Practitioner - Physical Therapist in Private Practice 3971642539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Club Rehab, Inc.Group PAC ID 0749193977, 11 clinicians

Practice addresses (Care Compare)

75 -5699 Kopiko St
Kailua Kona, HI 96740-3651
Phone (808) 329-7744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501011256MIMDOrthopedic Physical Therapist
PT-3910HIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Club Rehab, Inc. Orthopedic CurrentSince Feb 1, 2022 Accepting new patients
Physical Therapy Services of Chelsea, LLC Orthopedic Past Accepting new patients
Physical Therapy Services of Lansing, LLC Orthopedic Past Accepting new patients
Physical Therapy Services of West Michigan LLC Orthopedic PastSince Jun 1, 2006 Accepting new patients

Locations

75-5699 Kopiko St
Kailua Kona, HI 96740
Phone (808) 329-7744

73-5590 Kauhola St
Ste A
Kailua Kona, HI 96740
Phone (808) 329-7744

73-5590 Kauhola St
Ste A
Kailua Kona, HI 96740

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1912918137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73-5590 KAUHOLA ST STE A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402610",
            "telephone_number": "808-329-7744",
            "fax_number": "808-334-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73-5590 KAUHOLA ST STE A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402610",
            "telephone_number": "808-329-7744",
            "fax_number": "808-334-1608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6563 W Main St",
            "address_2": "lower level",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490094051",
            "country_code": "US",
            "telephone_number": "269-372-8483",
            "fax_number": "269-372-6113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501011256",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "HI",
            "license": "PT-3910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SMITH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.