Individual provider Active NPI

Christina Dicarlo Smith, PA

  • Physician Assistant
  • Simpsonville, SC
National Provider Identifier
1043652118
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1969 Issued in SC
Practice address
35 Ray E Talley CT
Simpsonville, SC 29680-6772
Phone
(864) 967-7028
NPI assigned
Jul 18, 2013
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X TL1969 SC
Physician Assistant 363A00000X 1969 SC Primary

Addresses

Primary practice location

35 Ray E Talley CT
Simpsonville, SC 29680-6772

Mailing address

PO Box 749306
Atlanta, GA 30374-9306
Phone (678) 986-7500

Other practice location 1

1010 Woodside Ave
Greenville, SC 29611-3733
Phone (864) 537-0159

Other identifiers 1

IdentifierTypeStateIssuer
1709PAMedicaidSC

Other names 1

  • Christina Dicarlo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131120001042 SC Practitioner - Physician Assistant 9739315854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

6167 Braided Mane Pass SW
Aiken, SC 29803-7839
Phone (803) 648-1464

793 E Butler Rd
Mauldin, SC 29662-3223
Phone (864) 720-1442

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1969SCMDPediatric Nutrition Registered Dietitian
TL1969SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizon Family Health Services, Inc. CurrentSince Aug 29, 2016 Accepting new patients
New Horizon Family Health Services Inc CurrentSince Aug 29, 2016 Accepting new patients
Grace Internal Medicine LLC CurrentSince Oct 16, 2025 Accepting new patients
Woodruff Road Urgent Care Center, P.C. PastSince Dec 29, 2019 Accepting new patients
New Horizon Family Health Services Inc. PastSince Sep 10, 2023 Accepting new patients

Locations

130 Mallard St
Greenville, SC 29601
Phone (864) 233-1534

114B Hospital Dr
Simpsonville, SC 29681
Phone (864) 399-9070

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1043652118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749306",
            "telephone_number": "678-986-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 RAY E TALLEY CT",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806772",
            "telephone_number": "864-967-7028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Woodside Ave",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296113733",
            "country_code": "US",
            "telephone_number": "864-537-0159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTINA",
        "middle_name": "DICARLO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "TL1969",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1709PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "DICARLO",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.