Douglas N. Smith, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R2A78 Issued in MO

Practice address

3308 W Edgewood Dr
Suite B
Jefferson City, MO 65109-6891

Phone

(573) 893-7848

Fax

(573) 893-1984

NPI assigned

Nov 18, 2005

Last updated

Jun 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Capital Region Resident Clinic

  dba Capital Region Physicians - Downtown Urgent Care

  • General Practice Physician
  • Jefferson City, MO
  • NPI 1649514050
  NPD (past)
• Medical Foundation, Inc.

  • Family Medicine Physician
  • Meridian, MS
  • NPI 1609820539
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1043292691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1128",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651021128",
            "telephone_number": "573-893-7848",
            "fax_number": "573-893-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 W EDGEWOOD DR",
            "address_2": "SUITE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651096891",
            "telephone_number": "573-893-7848",
            "fax_number": "573-893-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DOUGLAS",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO-82",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R2A78",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "DO-82",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009933720",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080162220",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF AL",
            "identifier": "51097631",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie R Smith, M.D.
• Carol Amy Gamm Smith, M.A.
• Catherine Corrigan Smith, NNP
• Chrystala Smith
• Cynthia Diane Smith, LPN
• James Marion Smith, LPC
• Jenna Smith, LMSW
• Joanna P. Smith, PA-C
• Loretta Smith, APN
• Marcey Smith, LPC

• Family Medicine Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.