NPIMap

Individual provider Active NPI

Roger A. Smith, M.D.

  • Internal Medicine Physician
  • Wisner, LA
National Provider Identifier
1023045671
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
018530 Issued in LA
Practice address
126 Watson Rd
Wisner, LA 71378-4660
Phone
(318) 724-7008
Fax
(318) 724-7646
NPI assigned
Jun 27, 2006
Last updated
Aug 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 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 018530 LA Primary

Addresses

Primary practice location

126 Watson Rd
Wisner, LA 71378-4660

Mailing address

PO Box 8
307 Chisum Street
Sicily Island, LA 71368-0008
Phone (318) 389-5727

Other identifiers 3

IdentifierTypeStateIssuer
248612YJCOtherLAMEDICARE PTAN
1386839MedicaidLA
110102447OtherLARAILROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address roger.smith.p1@direct.rfcatahoulaparish1.nextgenshare.com Health Information Exchange (HIE)
Direct Messaging Address roger.smith.p1@direct.rfcatahoulaparish1.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20070414000106 LA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3971400565 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Louisiana State University School of Medicine in Shreveport, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2106 Loop Rd
Winnsboro, LA 71295-3344
Phone (318) 412-5265

307 Chisum St
Sicily Island, LA 71368-4807
Phone (318) 389-5727

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18530LAMDSocial Worker
018530LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catahoula Parish Hospital District No 2 CurrentSince Feb 16, 2009 Accepting new patients
Franklin Parish Hospital Service Dist 1 CurrentSince Jul 2, 2012 Accepting new patients
Franklin Parish Hospital Service Dist 1 CurrentSince Jul 2, 2012 Accepting new patients
Catahoula Parish Hospital District No 2 CurrentSince Feb 16, 2009 Accepting new patients
Winnsboro Opco LLC Past Accepting new patients
Hospice TLC, Inc Past Accepting new patients
Southern Osteoporosis Service Internal Medicine Past Accepting new patients
Camellia Hospice of East Louisiana, LLC Past Accepting new patients
Catahoula Parish Hospital District No 2 Past Accepting new patients
Plantation Oaks Nursing & Rehabilitation Center LLC Past Accepting new patients
Mary Anna Nursing Home Inc Past Accepting new patients
Columns SNF Operations LLC Past Accepting new patients

Locations

100 Serio Blvd
Ferriday, LA 71334
Phone (318) 389-5727

307 Chisum St
Sicily Island, LA 71368
Phone (318) 389-5727

2104 Loop Rd
Ste C
Winnsboro, LA 71295
Phone (318) 435-4571

2106 Loop Rd
Winnsboro, LA 71295
Phone (318) 282-8482

Interoperability endpoints

  • Direct secure messaging: roger.smith.p1@direct.rfcatahoulaparish1.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Legacy Nursing & Rehabilitation of WinnsboroWinnsboro, LA, CCN 195392 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2019
Aug 1, 2019
The Columns Rehabilitation and Healthcare CenterJonesville, LA, CCN 195478 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 28, 2023
Dec 28, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Columns SNF Operations LLC

    dba The Columns Healthcare Center

    • Skilled Nursing Facility
    • Jonesville, LA
    • NPI 1942078522

    Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Winnsboro Opco LLC

    dba Legacy Nursing and Rehabilitation of Winnsboro

    • Skilled Nursing Facility
    • Winnsboro, LA
    • NPI 1275180655

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 12

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1023045671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8",
            "address_2": "307 CHISUM STREET",
            "city": "SICILY ISLAND",
            "state": "LA",
            "postal_code": "713680008",
            "telephone_number": "318-389-5727",
            "fax_number": "318-389-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 WATSON RD",
            "city": "WISNER",
            "state": "LA",
            "postal_code": "713784660",
            "telephone_number": "318-724-7008",
            "fax_number": "318-724-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROGER",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "018530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "248612YJC",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386839",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110102447",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roger.smith.p1@direct.rfcatahoulaparish1.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "126 Watson Rd",
            "city": "Wisner",
            "state": "LA",
            "country_code": "US",
            "postal_code": "713784660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roger.smith.p1@direct.rfcatahoulaparish1.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "307 Chisum St",
            "city": "Sicily Island",
            "state": "LA",
            "country_code": "US",
            "postal_code": "713684807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wisner, LA

Sources for this page

Verify at the official NPI Registry.