NPIMap

Organization Active NPI

Smith & Prothero Physical Therapy LLC

  • Orthopedic Physical Therapist
  • Havre de Grace, MD
National Provider Identifier
1942200621
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
SMITH & PROTHERO PHYSICAL THERAPY LLC
Practice address
807A S Union Ave
Havre de Grace, MD 21078-3610
Phone
(410) 939-2262
Fax
(410) 939-7119
NPI assigned
Jul 26, 2005
Last updated
Oct 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Authorized official

Name
Mr. William Charles Smith, PTNPI 1396745469
Title
Member
Phone
(410) 939-2262

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
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

807A S Union Ave
Havre de Grace, MD 21078-3610

Mailing address

807A S Union Ave
Havre de Grace, MD 21078-3610
Phone (410) 939-2262

Other practice location 1

1131 Baltimore Pike
Bel Air, MD 21014-5132
Phone (410) 838-6070

Other identifiers 3

IdentifierTypeStateIssuer
5874017-00MedicaidMD
LS73SMOtherMDCAREFIRST BC/BS
CB2775OtherMDRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060221000794 MD Part B Supplier - Clinic/Group Practice 9335155860 Receives reassigned benefits from 9 practitioners
Practice locations: Bel Air, MD; Havre de Grace, MD
O20201210002148 MD DME Supplier - Independently-Practicing Physical Therapist 9335155860 Practice locations: Havre de Grace, MD

National Provider Directory

National Provider Directory
Tax ID family
Smith Prothero PT LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1131 Baltimore Pike
Ste B
Bel Air, MD 21014
Phone (410) 838-6070

807 S Union Ave
#A
Havre de Grace, MD 21078
Phone (410) 939-2262

807A S Union Ave
Hvre de Grace, MD 21078
Phone (410) 939-2262

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1942200621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807A S UNION AVE",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783610",
            "telephone_number": "410-939-2262",
            "fax_number": "410-939-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807A S UNION AVE",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783610",
            "telephone_number": "410-939-2262",
            "fax_number": "410-939-7119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1131 Baltimore Pike",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "210145132",
            "country_code": "US",
            "telephone_number": "410-838-6070",
            "fax_number": "410-838-6961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SMITH & PROTHERO PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "410-939-2262",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5874017-00",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC/BS",
            "identifier": "LS73SM",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB2775",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.