Organization Active NPI

James D. Smith, P.C.

  • Family Medicine Physician
  • Kirksville, MO
National Provider Identifier
1093835928
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32793 Issued in MO
Legal business name
JAMES D. SMITH, P.C.
Practice address
1108 E Patterson St
Suite 10
Kirksville, MO 63501-4002
Phone
(660) 665-4265
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Authorized official

Name
Dr. James Donald Smith
Title
Owner
Phone
(660) 665-4265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 32793 MO Primary

Addresses

Primary practice location

1108 E Patterson St
Suite 10
Kirksville, MO 63501-4002

Mailing address

1108 East Patterson
Suite 10
Kirksville, MO 63501-1053

Other identifiers 2

IdentifierTypeStateIssuer
240833608MedicaidMO
501886709MedicaidMO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1093835928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 EAST PATTERSON",
            "address_2": "SUITE 10",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635011053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 E PATTERSON ST",
            "address_2": "SUITE 10",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014002",
            "telephone_number": "660-665-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES D. SMITH, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-665-4265",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "32793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240833608",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "501886709",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.