Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1508917543 Deactivated / Inactive NPI Male Practitioner

Kenneth C Smith , PT

Physical Therapist • Mount Vernon, IL

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kenneth Smith has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 16, 2007
NPI Deactivation Date October 11, 2024
Total Practice Duration ~17 Years of Practice (2007 – 2024)

Professional Overview & Biography Verified Profile Summary

Kenneth Smith, PT was a registered Physical Therapist practicing in Mount Vernon, IL. Throughout an active medical career spanning 17 years, Kenneth Smith provided care at the practice location at 3307 BROADWAY ST until profile deactivation on 2024-10-11.

Practice Location & Contact Primary Location

Practice Address

3307 Broadway St
Suite 140

Mount Vernon, IL 628642347

Telephone 6182447200
Associated Practice Facility / Clinic
🏢 Care First Medical Center Facility NPI 1598777435

Specialty Benchmarks & Practice Insights

Comparative analytics for Physical Therapist in Mount Vernon, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.1 Yrs
State Avg: 16.6 Yrs
Regional Practice Density
31 Specialists

Practicing in Mount Vernon, IL (12173 Statewide)

Telehealth Adoption Rate
3.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physical Therapist Primary Specialty

NUCC Taxonomy Code: 225100000X

Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs: 1.Diagnose and manage movement dysfunction and enhance physical and functional abilities. 2.Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health. 3.Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries. 4.Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems. 5.Address the negative effects attributable to unique personal and environmental factors as they relate to human performance. 6.PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
James Keeler , PA-C

Physician Assistant - Medical

NPI 1346376274

Physician Assistant (Certified)

Marillen Wells

Dietitian, Registered

NPI 1619989555
Shirley Dallmier , PA

Physician Assistant

NPI 1750497061

Physician Assistant

Dr. Veena Gupta , MD

Family Medicine

NPI 1790713899

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated October 11, 2024

Record deactivated on October 11, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 3307 BROADWAY ST, SUITE 140, MOUNT VERNON, IL 628642347 (Tel: 6182447200)

📍
Updated Business Mailing Address July 08, 2007

Registered at 2665 SNEED RD, CARBONDALE, IL 629020443 (Tel: 6189641647)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as KENNETH SMITH, P.T.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physical Therapist

🟢
Initial NPI Registration & Enumeration January 16, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Kenneth Smith. Be the first to share your experience!

Sign in to leave a review for Kenneth Smith

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1508917543
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 16, 2007
Last Update: July 08, 2007
Deactivation Date: October 11, 2024

Mailing Address

2665 Sneed Rd

Carbondale, IL 629020443

Phone: 6189641647

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.