Individual provider Active NPI

Christopher Smith

  • Pediatrics Physician
  • Trinity, FL
National Provider Identifier
1124480330
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME145522 Issued in FL
Practice address
2137 Little Rd
Trinity, FL 34655-4410
Phone
(727) 372-6760
Fax
(727) 372-6808
NPI assigned
Mar 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME145522 FL Primary
Pediatric Sports Medicine Physician 2080S0010X ME145522 FL

Addresses

Primary practice location

2137 Little Rd
Trinity, FL 34655-4410

Mailing address

2137 Little Rd
Trinity, FL 34655-4410
Phone (727) 372-6760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME145522FLMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Lake Pediatrics Pediatrics CurrentSince Jun 18, 2023 Accepting new patients

Locations

200 Pine Ave N
Oldsmar, FL 34677

4156 Woodlands Pkwy
Ste B
Palm Harbor, FL 34685
Phone (727) 372-6760

2137 Little Rd
Trinity, FL 34655
Phone (727) 372-6760

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60913

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1458950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1124480330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554410",
            "telephone_number": "727-372-6760",
            "fax_number": "727-372-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 LITTLE RD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554410",
            "telephone_number": "727-372-6760",
            "fax_number": "727-372-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-26",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME145522",
            "primary": true
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "FL",
            "license": "ME145522",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.