Individual provider Active NPI

Spencer Reid Smith, RPH

  • Pharmacist
  • Americus, GA
National Provider Identifier
1083678817
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
017305 Issued in GA
Practice address
611 E Lamar St Ste B
Americus, GA 31709-3744
Phone
(229) 928-9010
Fax
(229) 928-4477
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 017305 GA Primary

Addresses

Primary practice location

611 E Lamar St Ste B
Americus, GA 31709-3744

Mailing address

116 N Valhalla CT
Cordele, GA 31015-9308
Phone (229) 273-7513

Other identifiers 1

IdentifierTypeStateIssuer
327980256AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor'S Pharmacy-Vital Care, Inc. Past Accepting new patients
Doctor'S Pharmacy-Vital Care, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1083678817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 N VALHALLA CT",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310159308",
            "telephone_number": "229-273-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E LAMAR ST STE B",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093744",
            "telephone_number": "229-928-9010",
            "fax_number": "229-928-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SPENCER",
        "middle_name": "REID",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "017305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "327980256A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Americus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.