Active NPI
Peachie Smith, PT
- Physical Therapist
- Paw Paw, MI
National Provider Identifier
1962701664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501012498
- Practice address
- 451 Health Pkwy
Paw Paw, MI 49079-8242 - Phone
- (269) 657-1490
- NPI assigned
- Mar 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 5501012498 | MI | Primary |
Addresses
Primary practice location
451 Health Pkwy
Paw Paw, MI 49079-8242
Mailing address
6810 Marlow St
Portage, MI 49024-3341
Phone (906) 322-7333
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501012498 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563235200000",
"number": "1962701664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6810 MARLOW ST",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490243341",
"telephone_number": "906-322-7333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 HEALTH PKWY",
"city": "PAW PAW",
"state": "MI",
"postal_code": "490798242",
"telephone_number": "269-657-1490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "PEACHIE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-21",
"last_updated": "2019-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501012498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paw Paw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.