Individual provider Active NPI

Laura K Smith, PA-C

  • Physician Assistant
  • Spencer, WV
National Provider Identifier
1104978576
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1201 Issued in WV
Practice address
146 Williams Dr
Spencer, WV 25276-1826
Phone
(304) 927-8138
Fax
(304) 927-8198
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1201 WV Primary

Addresses

Primary practice location

146 Williams Dr
Spencer, WV 25276-1826

Mailing address

146 Williams Dr
Spencer, WV 25276-1826
Phone (304) 927-8138

Other identifiers 1

IdentifierTypeStateIssuer
3810006054MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20070706000142 WV Practitioner - Physician Assistant 9032219910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Development Co.Group PAC ID 4183527476, 65 clinicians

Practice addresses (Care Compare)

200 Hospital Dr
Spencer, WV 25276-1050
Phone (304) 927-4444

7313 Charleston Rd
Walton, WV 25286-9613
Phone (304) 577-6815

Hospital & facility affiliations

  • Roane General Hospital Hospital, Spencer, WV, CCN 511306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Development Co CurrentSince Oct 13, 2022 Accepting new patients
Hospital Development Co CurrentSince Oct 13, 2022 Accepting new patients
Hospital Development Co Current Accepting new patients

Locations

1024 Arnoldsburg Rd
Arnoldsburg, WV 25234
Phone (304) 655-6742

200 Hospital Dr
Spencer, WV 25276
Phone (304) 927-4444

300 Hospital Dr
Spencer, WV 25276
Phone (304) 927-6136

94 School Dr
Walton, WV 25286
Phone (304) 577-6815

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.

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1104978576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 WILLIAMS DR",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761826",
            "telephone_number": "304-927-8138",
            "fax_number": "304-927-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 WILLIAMS DR",
            "city": "SPENCER",
            "state": "WV",
            "postal_code": "252761826",
            "telephone_number": "304-927-8138",
            "fax_number": "304-927-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAURA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "1201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810006054",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, WV

Sources for this page

Verify at the official NPI Registry.