Active NPI
James Smith, M.D.
- Pediatrics Physician
- Gilbert, AZ
National Provider Identifier
1013980473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 14623
- Practice address
- 2550 E Guadalupe Rd
#115
Gilbert, AZ 85234-5114 - Phone
- (480) 214-2300
- Fax
- (480) 214-2300
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 14623 | AZ | Primary |
Addresses
Primary practice location
2550 E Guadalupe Rd
#115
Gilbert, AZ 85234-5114
Mailing address
6301 S McClintock Dr
#101
Tempe, AZ 85283-3392
Phone (480) 214-2300
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00014255 | Other | AZ | BANNER HEALTH PLAN |
| 2573620 | Other | AZ | DEPT OF ECONOMIC SECURITY |
| 014623 | Other | AZ | MAYO INSURANCE |
| 1Z6558 | Other | AZ | HEALTHNET |
| 257362 | Medicaid | AZ | |
| AZ0807330 | Other | AZ | BLUE CROSS BLUE SHIELD |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14623 | AZ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013980473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6301 S MCCLINTOCK DR",
"address_2": "#101",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852833392",
"telephone_number": "480-214-2300",
"fax_number": "480-214-2301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 E GUADALUPE RD",
"address_2": "#115",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852345114",
"telephone_number": "480-214-2300",
"fax_number": "480-214-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JAMES",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "14623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BANNER HEALTH PLAN",
"identifier": "00014255",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF ECONOMIC SECURITY",
"identifier": "2573620",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAYO INSURANCE",
"identifier": "014623",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "1Z6558",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "257362",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AZ0807330",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, 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.