Ethel L Smith, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

31510 Issued in GA

Practice address

2020 Honey Creek Pkwy SE
Conyers, GA 30013

Phone

(770) 919-0813

Fax

(770) 929-3868

NPI assigned

Oct 31, 2005

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

Enrolled in GA

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Complexcare Medical Group Southeast H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1083508238

  GA

  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  GA

  Medicare reassignment NPD
• Georgia Clinic, PC

  • Multi-Specialty Clinic/Center
  • Dunwoody, GA
  • NPI 1609816123

  Family Medicine

  NPD (past)
• Park Central Family Practice, Inc.

  • Family Medicine Physician
  • Decatur, GA
  • NPI 1922104306
  NPD (past)
• The Hospital Authority of Monroe County, Georgia

  • Critical Access Hospital
  • Forsyth, GA
  • NPI 1770684284
  NPD (past)
• Complexcare Medical Group Midwest M PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1528851607
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104817014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 HONEY CREEK PKWY SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30013",
            "telephone_number": "770-919-0813",
            "fax_number": "770-929-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 HONEY CREEK PKWY SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30013",
            "telephone_number": "770-919-0813",
            "fax_number": "770-929-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ETHEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "31510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Smiley, FNP-C
• Smith Emeri Smith LLC
• Alexis Smith
• Crystal M Smith
• Danyelle M Smith, FNP
• Eulanda S Smith
• Harmon Andrew Smith, M.D.
• Kaitlyn Smith, PA-C
• Kanisha Smith
• Khaliliah Kendra Smith

• Family Medicine Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.