Individual provider Active NPI

Richard Lyndon Smith Jr., M.D.

  • Internal Medicine Physician
  • Warner Robins, GA
National Provider Identifier
1023043130
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
021818 Issued in GA
Practice address
1260 Russell Pkwy
Warner Robins, GA 31088-5540
Phone
(478) 929-4100
Fax
(478) 329-8814
NPI assigned
Jul 11, 2006
Last updated
Nov 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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 021818 GA Primary

Addresses

Primary practice location

1260 Russell Pkwy
Warner Robins, GA 31088-5540

Mailing address

PO Box 8309
Warner Robins, GA 31095-8309
Phone (478) 929-4100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110907001426 GA Practitioner - Internal Medicine 2668642349 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021818GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Hospitals Inc CurrentSince Jul 15, 2011 Accepting new patients
Houston Hospitals Inc CurrentSince Jul 15, 2011 Accepting new patients
Houston Primary Care Physicians, LLC Internal Medicine PastSince Sep 11, 2022 Accepting new patients

Locations

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

1601 Watson Blvd
Ste 140B
Warner Robins, GA 31093
Phone (478) 922-4281

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1023043130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8309",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310958309",
            "telephone_number": "478-929-4100",
            "fax_number": "478-329-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 RUSSELL PKWY",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885540",
            "telephone_number": "478-929-4100",
            "fax_number": "478-329-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RICHARD",
        "middle_name": "LYNDON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "021818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.