Active NPI
Henry E Smoak III, MD
- Emergency Medicine Physician
- Bradenton, FL
National Provider Identifier
1033153580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME36892
- Practice address
- 206 2ND St E
Bradenton, FL 34208-1042 - Phone
- (941) 746-5111
- NPI assigned
- Jun 15, 2006
- Last updated
- Oct 7, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 45395 | CO | |
| Emergency Medicine Physician | 207P00000X | ME36892 | FL | Primary |
Addresses
Primary practice location
206 2ND St E
Bradenton, FL 34208-1042
Mailing address
14050 NW 14TH St
Suite 190
Sunrise, FL 33323-2865
Phone (800) 424-3672
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55205887 | Medicaid | CO | |
| 039499800 | Medicaid | FL |
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 |
|---|---|---|---|
| 45395 | CO | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inphynet Contracting Services LLC | Emergency Medicine | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Delray Beach, FL
- NPI 1073556767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223337600000",
"number": "1033153580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14050 NW 14TH ST",
"address_2": "SUITE 190",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232865",
"telephone_number": "800-424-3672",
"fax_number": "954-377-3042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 2ND ST E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342081042",
"telephone_number": "941-746-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMOAK",
"first_name": "HENRY",
"middle_name": "E",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2008-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "45395",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME36892",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55205887",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "039499800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.