John Smith

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16645 Issued in NC

Practice address

412 W Central Ave
Fitzgerald, GA 31750-2442

Phone

(229) 425-4185

NPI assigned

Sep 20, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1982152930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 W CENTRAL AVE",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317502442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W CENTRAL AVE",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317502442",
            "telephone_number": "229-425-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "16645",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210614",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Michelle Schell
• James Benjamin Shiflett Jr., DPT
• Antonio R Sison, M.D.
• Smile Mission Fitzgerald LLC
• Anna Nicole Smith
• Judith Elaine Smith, M.DIV
• Lynne D Smith, F.N.P.-C
• Kelly R. Sosebee, MHE,SLP
• South Central Primary Care Center, Inc
• South Central Primary Care Center, Inc

• Physical Therapist in Fitzgerald, GA
• Providers in Fitzgerald, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.