NPIMap

Organization Active NPI

Jeffrey Smith, MD PC

Doing business as Great Lakes Surgical Associates

  • Specialist
  • Alma, MI
National Provider Identifier
1023196458
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301052770 Issued in MI
Legal business name
JEFFREY SMITH, MD PC
Doing business as
Great Lakes Surgical Associates
Practice address
315 E Warwick Dr
#3
Alma, MI 48801-1083
Phone
(989) 463-6699
Fax
(989) 466-2574
NPI assigned
Nov 2, 2006
Last updated
May 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Authorized official

Name
Dr. Jeffrey F Smith, M.D.NPI 1831197979
Title
President
Phone
(989) 463-6699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 4301052770 MI Primary

Addresses

Primary practice location

315 E Warwick Dr
#3
Alma, MI 48801-1083

Mailing address

315 E Warwick Dr
#3
Alma, MI 48801-1083
Phone (989) 463-6699

Other names 1

  • Great Lakes Surgical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080501000304 MI Part B Supplier - Clinic/Group Practice 3870672843 Receives reassigned benefits from 8 practitioners
Practice locations: Alma, MI; Clare, MI; Houghton Lake, MI; Midland, MI; Mt Pleasant, MI

National Provider Directory

National Provider Directory

Locations

4201 Campus Ridge Dr
Ste 2700
Midland, MI 48640

4201 Campus Ridge Dr
Ste 4050
Midland, MI 48640
Phone (989) 331-7940

4851 E Pickard St
Ste 2200
Mt Pleasant, MI 48858

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1830

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1023196458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E WARWICK DR",
            "address_2": "#3",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488011083",
            "telephone_number": "989-463-6699",
            "fax_number": "989-466-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E WARWICK DR",
            "address_2": "#3",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488011083",
            "telephone_number": "989-463-6699",
            "fax_number": "989-466-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY SMITH, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-463-6699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301052770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Lakes Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alma, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.