Lisa M Smith, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

002904 Issued in GA

Practice address

107 Main St
Plains, GA 31780-5570

Phone

(229) 824-7757

Fax

(229) 824-3497

NPI assigned

Oct 19, 2005

Last updated

Jul 13, 2026By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114916475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196",
            "city": "PLAINS",
            "state": "GA",
            "postal_code": "317800196",
            "telephone_number": "229-824-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MAIN ST",
            "city": "PLAINS",
            "state": "GA",
            "postal_code": "317805570",
            "telephone_number": "229-824-7757",
            "fax_number": "229-824-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "002904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "002904",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanika Price
• Neelima Puppala, M.D.
• Jan Roland Contreras Renolayan, PT
• Ceretta Dawn Sheppard, LMFT
• Kristin Murrah Smith
• Betty Jo Songer, FNP

• Medical Physician Assistant in Plains, GA
• Providers in Plains, GA by specialty
• Medical Physician Assistant 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.