Individual provider Active NPI

David L Smith, MD

  • Ph.D. Medical Genetics
  • Memphis, TN
National Provider Identifier
1124175542
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ph.D. Medical GeneticsTaxonomy code 170100000X
License
14078 Issued in TN
Practice address
4321 Fayette Rd
Memphis, TN 38128-5723
Phone
(901) 386-6399
Fax
(901) 372-2135
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X 14078 TN Primary

Addresses

Primary practice location

4321 Fayette Rd
Memphis, TN 38128-5723

Mailing address

4321 Fayette Rd
Memphis, TN 38128-5723
Phone (901) 386-6399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20151214000020 TN Practitioner - Internal Medicine 5496065534 Practice locations: Memphis, TN

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4321 Fayette Rd
Memphis, TN 38128-5723
Phone (901) 386-6399

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14078TNMDPh.D. Medical Genetics

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124175542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 FAYETTE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285723",
            "telephone_number": "901-386-6399",
            "fax_number": "901-372-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 FAYETTE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285723",
            "telephone_number": "901-386-6399",
            "fax_number": "901-372-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "TN",
            "license": "14078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.