Charles Jackson Smith, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

9851 Issued in ND

Practice address

222 N 7TH St
Bismarck, ND 58501-4436

Phone

(701) 323-6000

Fax

(701) 323-5709

NPI assigned

Nov 28, 2006

Sex

Male

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)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124194535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5501",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585065501",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 7TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014436",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "JACKSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "ND",
            "license": "9851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13238",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Smiling Angel Home Care Service LLC
• Allison Smith
• Betty Smith, CSW/LMSW
• Cassandra Lauren Smith, LCAC
• Chad Smith
• Chelsie Jo Smith, MA
• Craig Donald Smith, M.D.
• Ebony S Smith
• Jeffrey A Smith, MD
• Jeremy O Smith, LBSW

• Nephrology Physician in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Nephrology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.