Individual provider Active NPI

Landon Smith

  • Nurse Practitioner
  • Freeland, MI
National Provider Identifier
1104383124
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704274252 Issued in MI
Practice address
5694 Midland Rd
Freeland, MI 48623-8845
Phone
(989) 695-4999
NPI assigned
Feb 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704274252 MI Primary

Addresses

Primary practice location

5694 Midland Rd
Freeland, MI 48623-8845

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190521002354 MI Practitioner - Nurse Practitioner 8123361839 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center GladwinGroup PAC ID 0143262915, 66 clinicians

Practice addresses (Care Compare)

335 E Houghton Ave
West Branch, MI 48661-1127
Phone (989) 345-8130

Hospital & facility affiliations

  • Mymichigan Medical Center Gladwin Hospital, Gladwin, MI, CCN 231325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Gladwin CurrentSince Oct 8, 2019 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Apr 23, 2019 Accepting new patients
Mymichigan Medical Center Alma Current Accepting new patients
Mymichigan Medical Center Alma CurrentSince Mar 27, 2020 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Oct 8, 2019 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Apr 23, 2019 Accepting new patients
Mymichigan Medical Center Alma Nurse Practitioner CurrentSince Mar 27, 2020 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Oct 8, 2019 Accepting new patients

Locations

321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957

2980 Wilder Rd
Ste B
Bay City, MI 48706
Phone (989) 509-3333

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

700 W 5th St
Clare, MI 48617
Phone (989) 386-9911

5694 Midland Rd
Freeland, MI 48623
Phone (989) 695-2123

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

1105 E Cedar Ave
Gladwin, MI 48624
Phone (989) 246-6490

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

3009 N Saginaw Rd
Midland, MI 48640
Phone (989) 633-1350

335 E Houghton Ave
West Branch, MI 48661
Phone (989) 343-3154

3691 W M 55
West Branch, MI 48661
Phone (989) 312-8104

Interoperability endpoints

  • Direct secure messaging: lsmith7327@mymichiganhealth.midirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1104383124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5694 MIDLAND RD",
            "city": "FREELAND",
            "state": "MI",
            "postal_code": "486238845",
            "telephone_number": "989-695-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704274252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeland, MI

Sources for this page

Verify at the official NPI Registry.