Individual provider Active NPI

Marianne Leigh Smith, M.D.

  • Psychiatry Physician
  • Southbridge, MA
National Provider Identifier
1033156732
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
74852 Issued in MA
Practice address
29 Pine St
G.B. Wells Human Services Center
Southbridge, MA 01550-1823
Phone
(508) 765-9167
Fax
(508) 764-2462
NPI assigned
Jun 1, 2006
Last updated
Jul 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 74852 MA Primary

Addresses

Primary practice location

29 Pine St
G.B. Wells Human Services Center
Southbridge, MA 01550-1823

Mailing address

22 Berwick St
Worcester, MA 01602-1406
Phone (508) 856-3220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20110629000747 MA Practitioner - Psychiatry 9436337094 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74852MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts Psychiatry CurrentSince Apr 10, 2024 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Apr 10, 2024 Accepting new patients

Organizations & group practices 2

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1033156732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BERWICK ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016021406",
            "telephone_number": "508-856-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 PINE ST",
            "address_2": "G.B. WELLS HUMAN SERVICES CENTER",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015501823",
            "telephone_number": "508-765-9167",
            "fax_number": "508-764-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARIANNE LEIGH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "74852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

Verify at the official NPI Registry.