Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kody Smith

Individual provider Physical Therapist · NPI 1104618610

Kody Smith is a Physical Therapist in Private Practice in Azle, Texas. Qualified in 2025, 1 year ago. Practices with Sportherapy LLC, a 44-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
1
Licensed in
TX
In the registry since
2025

Practice location Address checks out

245 W Main St
Azle, TX 76020-2927
Phone: (817) 270-2975
Fax: (817) 270-3596
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1406768 (TX)

Record details

NPI number1104618610
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 20, 2025
Last updated in NPPESMay 20, 2025
Certification dateMay 20, 2025
Mailing address1650 Lyndon Farm Ct Ste 300, Louisville, KY 40223-5005

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Sportherapy Llc — 44 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Azle