Active NPI
Beth Mirasola Smith, PT
- Physical Therapist
- Onalaska, WI
National Provider Identifier
1952496234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3152
- Practice address
- 1202 County Road PH Ste 100
Onalaska, WI 54650-8440 - Phone
- (608) 781-6828
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3152 | WI | Primary |
Addresses
Primary practice location
1202 County Road PH Ste 100
Onalaska, WI 54650-8440
Mailing address
1202 County Road PH Ste 100
Onalaska, WI 54650-8440
Phone (608) 781-6828
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3152 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leo J Bronston | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1952496234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 COUNTY ROAD PH STE 100",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546508440",
"telephone_number": "608-781-6828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1202 COUNTY ROAD PH STE 100",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546508440",
"telephone_number": "608-781-6828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "BETH",
"middle_name": "MIRASOLA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "3152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Onalaska, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.