Individual provider Active NPI

Elizabeth Brooke Johnson Smith, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1114490687
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08724 Issued in NC
Practice address
5241 Six Forks Rd Ste 100
Raleigh, NC 27609-4431
Phone
(919) 785-3400
NPI assigned
Jan 8, 2019
Last updated
Oct 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0010-08724 NC
Physician Assistant 363A00000X 0010-08724 NC Primary

Addresses

Primary practice location

5241 Six Forks Rd Ste 100
Raleigh, NC 27609-4431

Mailing address

PO Box 52411
Phoenix, AZ 85072-2411
Phone (919) 785-3400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address EBrooke.SmithPA.P1@direct.cnsa.nextgenshare.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190218001547 NC Practitioner - Physician Assistant 8628316619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Neurosurgical Clinic IncGroup PAC ID 1759315500, 52 clinicians

Practice addresses (Care Compare)

5838 Six Forks Rd
Suite 100
Raleigh, NC 27609-3893
Phone (919) 785-3400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Neurosurgical Clinic, Inc. CurrentSince Jan 8, 2025 Accepting new patients

Locations

12610 N Community House Rd
Ste 200
Charlotte, NC 28277
Phone (704) 405-1747

2109 Valleygate Dr
Ste 201
Fayetteville, NC 28304
Phone (910) 486-8880

2605 Hospital Rd
Goldsboro, NC 27534
Phone (919) 741-7502

3700 Symi Cir
Morehead City, NC 28557
Phone (252) 222-5888

5838 Six Forks Rd
Ste 100
Raleigh, NC 27609

110 Turner St
Southern Pines, NC 28387
Phone (910) 725-0361

4130 Oleander Dr
Ste 100
Wilmington, NC 28403
Phone (910) 200-5242

Interoperability endpoints

  • Direct secure messaging: ebrooke.smithpa.p1@direct.cnsa.nextgenshare.com
  • Direct secure messaging: esmith567048@directhisp.wakemed.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1114490687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52411",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850722411",
            "telephone_number": "919-785-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5241 SIX FORKS RD STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094431",
            "telephone_number": "919-785-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELIZABETH",
        "middle_name": "BROOKE JOHNSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-08",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-08724",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "EBrooke.SmithPA.P1@direct.cnsa.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "225 Baldwin Ave",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.