NPIMap

Individual provider Active NPI

Michael Warren Smith, MD

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1003830530
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200300709 Issued in NC
Practice address
6115 Park South Dr Ste 100
Charlotte, NC 28210-3281
Phone
(704) 554-8787
Fax
(704) 554-8774
NPI assigned
Jul 27, 2006
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200300709 NC Primary

Addresses

Primary practice location

6115 Park South Dr Ste 100
Charlotte, NC 28210-3281

Mailing address

6115 Park South Dr Ste 100
Charlotte, NC 28210-3281
Phone (704) 554-8787

Other identifiers 3

IdentifierTypeStateIssuer
891341GMedicaidNC
1003830530MedicaidNC
N00701MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317001246 NC Practitioner - Internal Medicine 4688564297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Carolina School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare PLLCGroup PAC ID 3476678053, 15 clinicians

Practice addresses (Care Compare)

6115 Park S Dr
Suite 100
Charlotte, NC 28210-3269

6115 Park S Dr
Suite 100
Charlotte, NC 28210-3281
Phone (704) 554-8787

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
64.05

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200300709NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare PLLC Internal Medicine CurrentSince Jan 16, 2023 Accepting new patients

Locations

6115 Park South Dr
Ste 100
Charlotte, NC 28210
Phone (704) 554-8787

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19260/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michael.smith.1@19260.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1003830530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 PARK SOUTH DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103281",
            "telephone_number": "704-554-8787",
            "fax_number": "704-554-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 PARK SOUTH DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103281",
            "telephone_number": "704-554-8787",
            "fax_number": "704-554-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200300709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891341G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003830530",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00701",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.