Individual provider Active NPI

Wesley Omar Smith, M.D.

  • Specialist
  • Tuscaloosa, AL
National Provider Identifier
1093771180
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5726 Issued in AL
Practice address
1780 McFarland Blvd N
Tuscaloosa, AL 35406-2136
Phone
(205) 345-7351
Fax
(205) 345-8476
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5726 AL Primary

Addresses

Primary practice location

1780 McFarland Blvd N
Tuscaloosa, AL 35406-2136

Mailing address

1400 Afflink PL
Suite 100
Tuscaloosa, AL 35406-2289
Phone (205) 366-9740

Other identifiers 1

IdentifierTypeStateIssuer
529800880MedicaidAL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5726ALMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Cancer Network, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1093771180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 AFFLINK PL",
            "address_2": "SUITE 100",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062289",
            "telephone_number": "205-366-9740",
            "fax_number": "205-344-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 MCFARLAND BLVD N",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062136",
            "telephone_number": "205-345-7351",
            "fax_number": "205-345-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WESLEY",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "5726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529800880",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.