Active NPI
William Smith Jr., MD
- Nephrology Physician
- Paradise Valley, AZ
National Provider Identifier
1013071646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 12089
- Practice address
- 6320 N 52ND PL
Paradise Valley, AZ 85253-4154 - Phone
- (602) 840-5467
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 12089 | AZ | Primary |
Addresses
Primary practice location
6320 N 52ND PL
Paradise Valley, AZ 85253-4154
Mailing address
6320 N 52ND PL
Paradise Valley, AZ 85253-4154
Phone (602) 840-5467
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12089 | Other | AZ | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12089 | AZ | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Kidney Institute, PLC | Nephrology | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Nephrology Physician
- Tempe, AZ
- NPI 1659316008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013071646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6320 N 52ND PL",
"city": "PARADISE VALLEY",
"state": "AZ",
"postal_code": "852534154",
"telephone_number": "602-840-5467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6320 N 52ND PL",
"city": "PARADISE VALLEY",
"state": "AZ",
"postal_code": "852534154",
"telephone_number": "602-840-5467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "WILLIAM",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "AZ",
"license": "12089",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "12089",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paradise Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.