Individual provider Active NPI

Benjamin Smith, D.O.

  • Family Medicine Physician
  • Dalton, GA
National Provider Identifier
1043621642
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
077315 Issued in GA
Practice address
1200 Memorial Dr
Dalton, GA 30720-2529
Phone
(706) 272-6000
NPI assigned
May 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 077315 GA Primary

Addresses

Primary practice location

1200 Memorial Dr
Dalton, GA 30720-2529

Mailing address

1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 272-6000

Other practice location 1

21 Commerce Pkwy
Adairsville, GA 30103-2009
Phone (770) 773-9201

Other identifiers 1

IdentifierTypeStateIssuer
003158924DMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bdsmith@hamilton.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20170928002849 GA Practitioner - Family Practice 7719252816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamilton Medical Center, IncGroup PAC ID 0446151179, 105 clinicians

Practice addresses (Care Compare)

1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 272-6000

Hospital & facility affiliations

  • Hamilton Medical Center Hospital, Dalton, GA, CCN 110001

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Medical Center, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Hamilton Physician Group Inc CurrentSince Apr 1, 2019 Accepting new patients
Adventist Health System Georgia Inc CurrentSince Sep 1, 2017 Accepting new patients

Locations

21 Commerce Pkwy
Adairsville, GA 30103
Phone (770) 769-4547

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

Interoperability endpoints

  • Direct secure messaging: bsmith18986@hhcs.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1043621642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 MEMORIAL DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202529",
            "telephone_number": "706-272-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MEMORIAL DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202529",
            "telephone_number": "706-272-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Commerce Pkwy",
            "address_purpose": "LOCATION",
            "city": "Adairsville",
            "state": "GA",
            "postal_code": "301032009",
            "country_code": "US",
            "telephone_number": "770-773-9201",
            "fax_number": "770-773-9219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-16",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "077315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003158924D",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdsmith@hamilton.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1200 Memorial Dr",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307202529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.