Individual provider Active NPI

Cheryl Lee Smith, M.D.

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1053603860
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301098848 Issued in MI
Practice address
22250 Providence Dr
Suite 500
Southfield, MI 48075-4825
Phone
(248) 849-3441
NPI assigned
May 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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 4301098848 MI Primary

Addresses

Primary practice location

22250 Providence Dr
Suite 500
Southfield, MI 48075-4825

Mailing address

27900 Woodmont St
Roseville, MI 48066-2717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20141031000280 MI Practitioner - Family Practice 9638390859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians

Practice addresses (Care Compare)

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 424-3000

16001 W 9 Mile Rd 3Rd FL
Providence Hospital Gastrology
Southfield, MI 48075-4818
Phone (248) 849-6033

16001 W 9 Mile Rd 3Rd Floor
Providence Hospital Gastrology
Southfield, MI 48075-4818
Phone (248) 849-6033

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

210 N Lafayette St
South Lyon, MI 48178-2048

22250 Providence Dr
Southfield, MI 48075-6211

22250 Providence Dr
FL 5
Southfield, MI 48075-4825
Phone (248) 849-3441

Hospital & facility affiliations

  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301098848MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital Family Medicine CurrentSince Sep 6, 2014 Accepting new patients
Henry Ford Health Providence Hospital Current Accepting new patients
Henry Ford Health Providence Hospital CurrentSince Sep 6, 2014 Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients

Locations

210 N Lafayette St
South Lyon, MI 48178
Phone (248) 437-1744

22250 Providence Dr
Ste 500
Southfield, MI 48075
Phone (248) 849-3441

22250 Providence Dr
Fl 5
Southfield, MI 48075
Phone (248) 849-3441

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

Interoperability endpoints

  • Direct secure messaging: cheryl.smith.1@16555.direct.athenahealth.com
  • Direct secure messaging: csmith1151761@direct.hfhs.org

Organizations & group practices 4

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": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1053603860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27900 WOODMONT ST",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480662717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "SUITE 500",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-849-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHERYL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-11",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301098848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.