Individual provider Active NPI

Levi Cory Smith, DPM

  • Podiatrist
  • Shenandoah, IA
National Provider Identifier
1043915648
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1356 Issued in WI
Practice address
300 Pershing Ave
Shenandoah, IA 51601-2355
Phone
(712) 246-7400
NPI assigned
Apr 3, 2023
Last updated
Jun 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Podiatrist 213E00000X 1356 WI Primary

Addresses

Primary practice location

300 Pershing Ave
Shenandoah, IA 51601-2355

Mailing address

300 Pershing Ave
Shenandoah, IA 51601-2355
Phone (712) 246-7400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251205001683 WI Practitioner - Podiatry 2163881046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Practice addresses (Care Compare)

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1356WIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Dec 31, 2025 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Nov 17, 2025 Accepting new patients
Gundersen Clinic LTD CurrentSince Dec 31, 2025 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Nov 17, 2025 Accepting new patients

Locations

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

Interoperability endpoints

  • Direct secure messaging: lsmith784134@direct.emplifyhealth.org

Organizations & group practices 5

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": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1043915648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PERSHING AVE",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012355",
            "telephone_number": "712-246-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PERSHING AVE",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012355",
            "telephone_number": "712-246-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LEVI",
        "middle_name": "CORY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "1356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, IA

Sources for this page

Verify at the official NPI Registry.