Organization Active NPI

Norma Smith MD PA

Doing business as Arkansas Vein Clinic and Skin Care

  • Medical Specialty Clinic/Center
  • Fort Smith, AR
National Provider Identifier
1083916894
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
NORMA SMITH MD PA
Doing business as
Arkansas Vein Clinic and Skin Care
Eastside Health & Gynecology
Practice address
8101 McClure Dr Ste 101
Fort Smith, AR 72916-6040
Phone
(479) 484-7100
Fax
(479) 478-7255
NPI assigned
Nov 30, 2010
Last updated
Oct 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Authorized official

Name
Ms. Michelle Ann Zulch
Title
Manager
Phone
(479) 484-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

8101 McClure Dr Ste 101
Fort Smith, AR 72916-6040

Mailing address

PO Box 11708
Fort Smith, AR 72917-1708
Phone (479) 484-7100

Other practice location 1

2713 S 74th St
Suite 204
Fort Smith, AR 72903
Phone (479) 484-7100 ext. 16

Other identifiers 1

IdentifierTypeStateIssuer
5G371OtherARAR BCBS

Other names 2

  • Arkansas Vein Clinic and Skin Care Doing business as
  • Eastside Health & Gynecology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110203000628 AR Part B Supplier - Clinic/Group Practice 1254511579 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Smith, AR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2049071Eastside Health & Gynecology8101 McClure Dr, Suite 101, Fort Smith, AR 72916Certificate of waiverOct 29, 2026

National Provider Directory

National Provider Directory

Locations

2713 S 74th St
Ste 204
Fort Smith, AR 72903
Phone (479) 274-3600

2713 S 74th St
Ste 301
Fort Smith, AR 72903
Phone (479) 314-4620

8101 McClure Dr
Ste 101
Fort Smith, AR 72916
Phone (479) 484-7100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1083916894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11708",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171708",
            "telephone_number": "479-484-7100",
            "fax_number": "479-478-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 MCCLURE DR STE 101",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166040",
            "telephone_number": "479-484-7100",
            "fax_number": "479-478-7255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2713 S 74th St",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "72903",
            "country_code": "US",
            "telephone_number": "479-484-7100 x16",
            "fax_number": "479-478-7255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORMA SMITH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "ZULCH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-484-7100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "5G371",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arkansas Vein Clinic and Skin Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastside Health & Gynecology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastside Health & Gynecology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.