Carol Louise Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00614200 Issued in NJ

Practice address

1387 Chews Landing Rd
Clementon, NJ 08021-2760

Phone

(856) 454-3104

Fax

(856) 842-5298

NPI assigned

Aug 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Harmony Bay Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Laurel Springs, NJ
  • NPI 1124663059
  NPD
• Amita Jha MD LLC

  • Psychiatry Physician
  • Rockville, MD
  • NPI 1992467740
  NPD

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1104225671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1387 CHEWS LANDING RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080212760",
            "telephone_number": "856-454-3104",
            "fax_number": "856-842-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1387 CHEWS LANDING RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080212760",
            "telephone_number": "856-454-3104",
            "fax_number": "856-842-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAROL",
        "middle_name": "LOUISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00614200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amit Sheth, PHARMD.
• Emily Shinault
• Adelyn N Simeone, BCBA
• SK Passion
• Angela Bianca Skelley
• Seri Marcia Smith
• Kenneth A Soffer, DMD
• Natalie Solan, LCSW
• Sr Lab Services
• Gregory Stakenburg

• Physician Assistant in Clementon, NJ
• Providers in Clementon, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; 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.