Organization Active NPI

Smartt Neurology PC

  • Neurology Physician
  • Carmel, IN
National Provider Identifier
1053505826
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
SMARTT NEUROLOGY PC
Practice address
9640 N Augusta Dr
Suite 412
Carmel, IN 46032-9600
Phone
(317) 872-4545
Fax
(317) 872-3959
NPI assigned
Sep 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Authorized official

Name
Jerry W Smartt Jr., MDNPI 1306850722
Title
President
Phone
(317) 872-4545

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

9640 N Augusta Dr
Suite 412
Carmel, IN 46032-9600

Mailing address

9640 N Augusta Dr
Suite 412
Carmel, IN 46032-9600
Phone (317) 872-4545

Other identifiers 2

IdentifierTypeStateIssuer
000000362840OtherINANTHEM BLUE SHIELD
200504240AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071017000009 IN Part B Supplier - Clinic/Group Practice 9931165826 Receives reassigned benefits from 1 practitioner
Practice locations: Carmel, IN

National Provider Directory

National Provider Directory

Locations

9640 Commerce Dr
Ste 412
Carmel, IN 46032
Phone (317) 662-0082

9660 Commerce Dr
Ste 202
Carmel, IN 46032

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1053505826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9640 N AUGUSTA DR",
            "address_2": "SUITE 412",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460329600",
            "telephone_number": "317-872-4545",
            "fax_number": "317-872-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 N AUGUSTA DR",
            "address_2": "SUITE 412",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460329600",
            "telephone_number": "317-872-4545",
            "fax_number": "317-872-3959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMARTT NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "SMARTT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-872-4545",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "000000362840",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200504240A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.