Samuel Smith, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305213833 Issued in VA

Practice address

272 Highland Drive
Lebanon, VA 24266

Phone

(276) 889-4090

Fax

(276) 889-4026

NPI assigned

Sep 16, 2020

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Lebanon Physical Therapy and Rehabilitative Services, LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Lebanon, VA
  • NPI 1619947678
  NPD

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1962018986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LEBANON PHYSICAL THERAPY & REHABILITATIVE SERVICES, LLC",
            "address_2": "P.O. BOX 1387",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-889-4090",
            "fax_number": "276-889-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 HIGHLAND DRIVE",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-889-4090",
            "fax_number": "276-889-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4979711",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Cherie Sexton, LPC
• Cora Grace Shelton, FNP
• Lorin Elise Shortt, MA, CCC-SLP
• Tyler Skeen
• Kelly Elizabeth Smith, LCSW, CSAC
• Southwest Regional Counseling Service Inc
• Vanessa Stacy
• Charles Seth Stanley, PT, DPT
• Steve Ball DDS PC
• Mandy Stiltner, RPH

• Physical Therapist in Lebanon, VA
• Providers in Lebanon, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.