Individual provider Active NPI

Carl Lynwood Smith, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Raleigh, NC
National Provider Identifier
1104869007
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
200101611 Issued in NC
Practice address
11550 Common Oaks Dr
Suite 100
Raleigh, NC 27614-7298
Phone
(919) 453-5740
Fax
(919) 313-1276
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 200101611 NC Primary
Physical Medicine & Rehabilitation Physician 208100000X D0047271 MD
Physical Medicine & Rehabilitation Physician 208100000X C1-0004187 DE

Addresses

Primary practice location

11550 Common Oaks Dr
Suite 100
Raleigh, NC 27614-7298

Mailing address

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20100724000264 NC Practitioner - Physical Medicine and Rehabilitation 5395877427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Pittsburgh School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C1-0004187DEMDPhysical Medicine & Rehabilitation Physician
D0047271MDMDPhysical Medicine & Rehabilitation Physician
200101611NCMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Physical Medicine & Rehabilitation CurrentSince Nov 5, 2012 Accepting new patients
Emergeortho PA CurrentSince Nov 5, 2012 Accepting new patients
Maria Parham Nephrology & Hypertension Past Accepting new patients
Maria Parham Anesthesia and Physiatry Center, Inc Past Accepting new patients

Locations

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

11550 Common Oaks Dr
Ste 100
Raleigh, NC 27614
Phone (919) 453-5740

3100 Duraleigh Rd
Ste 100
Raleigh, NC 27612
Phone (919) 571-6465

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Interoperability endpoints

  • Direct secure messaging: carl.smith.1@847.direct.athenahealth.com

Organizations & group practices 4

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1104869007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WILLIAM PENN PLZ",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042150",
            "telephone_number": "919-220-5255",
            "fax_number": "919-313-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 COMMON OAKS DR",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147298",
            "telephone_number": "919-453-5740",
            "fax_number": "919-313-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CARL",
        "middle_name": "LYNWOOD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "200101611",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D0047271",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "DE",
            "license": "C1-0004187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.