Active NPI
Cassie Ly Smith
- Physical Therapist
- Ponchatoula, LA
National Provider Identifier
1972177418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 07260
- Practice address
- 1560 US-51
Ponchatoula, LA 70454 - Phone
- (985) 229-2112
- NPI assigned
- May 19, 2021
- 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 | 07260 | LA | Primary |
Addresses
Primary practice location
1560 US-51
Ponchatoula, LA 70454
Mailing address
409 N Spruce St
Hammond, LA 70401-3155
Phone (985) 974-1148
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2007
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
127 W Broad St
Suite 850
Lake Charles, LA 70601-4394
409 N Spruce St
Hammond, LA 70401-3155
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07260 | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1972177418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 N SPRUCE ST",
"city": "HAMMOND",
"state": "LA",
"postal_code": "704013155",
"telephone_number": "985-974-1148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 US-51",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "70454",
"telephone_number": "985-229-2112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "CASSIE",
"middle_name": "LY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-19",
"last_updated": "2021-05-19",
"certification_date": "2021-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "LA",
"license": "07260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponchatoula, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.