Collin-Jamal Smith

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2023-03374 Issued in NC

Practice address

102 Mason Farm Rd
Chapel Hill, NC 27514-4617

Phone

(984) 974-4462

Fax

(919) 843-9355

NPI assigned

Apr 22, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

DermatologyAlso: Internal Medicine

Education

University of North Carolina at Chapel Hill School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moses Cone Physician Services, IncGroup PAC ID 4284782210, 397 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.12 of 100Reported as group

Quality

80.57

Promoting interoperability

100

Improvement activities

40

Cost

77.81

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: csmith708227@direct.conehealth.com
• Direct secure messaging: csmith284897@directhisp.wakemed.org

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.

• Moses Cone Physician Services, Inc.

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1093953127
  Medicare reassignment Care Compare group NPD
• Moses Cone Physician Services Inc

  • Hospitalist Physician
  • Greensboro, NC
  • NPI 1326363383
  NPD
• Moses Cone Physician Services, Inc

  • Dermatology Physician
  • Burlington, NC
  • NPI 1548702186
  NPD
• Moses Cone Physician Services Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Reidsville, NC
  • NPI 1780004556
  NPD (past)

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1093335820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MASON FARM RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144617",
            "telephone_number": "984-974-4462",
            "fax_number": "919-843-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MASON FARM RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144617",
            "telephone_number": "984-974-4462",
            "fax_number": "919-843-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1734 Westbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NC",
            "postal_code": "272158721",
            "country_code": "US",
            "telephone_number": "336-584-5801",
            "fax_number": "336-584-5860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "COLLIN-JAMAL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2023-03374",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "261580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csmith708227@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1734 Westbrook Ave",
            "city": "Burlington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272158721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Jane Smith, RD
• Benjamin Allen Smith, MD
• Cambray Smith, PHD
• Ciara G. Smith, MD
• Cole Smith, M.D.
• Cynthia E Smith, OTR/L
• Dana Marie Smith, M.D.
• Darryl Frederick Smith, PHD
• David A Smith, M.D.
• Elizabeth Fawcett Smith, MT-BC

• Dermatology Physician in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.