Charles Gray Smith, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TN15753 Issued in TN

Practice address

400 W Crawford Ave
Monterey, TN 38574

Phone

(931) 839-2224

Fax

(931) 839-2368

NPI assigned

Sep 28, 2005

Last updated

Jul 13, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Family Medical Community Healthcare, PLLC

  • Family Medicine Physician
  • Lebanon, TN
  • NPI 1861366387
  NPD (past)

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

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1144217803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W CRAWFORD AVE",
            "city": "MONTEREY",
            "state": "TN",
            "postal_code": "385741166",
            "telephone_number": "931-839-2224",
            "fax_number": "931-839-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W CRAWFORD AVE",
            "city": "MONTEREY",
            "state": "TN",
            "postal_code": "38574",
            "telephone_number": "931-839-2224",
            "fax_number": "931-839-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "GRAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-28",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "TN15753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3846287",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Restorative Minds Behavioral Health Services, PLLC
• Mark Anthony Sherfey, MD
• Daniel Evin Simpkins, LCSW
• Daniel Sitton
• Alyssa Smith, FNP-C
• Ree Rene Smith, APN, FNP-C
• State of Tennessee (Monterey-Putnam County Health Department)
• Larry Bradford Vaughn, PHARMD
• Michael E. West, R.PH.
• Heather H Wilson, GNP

• Family Medicine Physician in Monterey, TN
• Providers in Monterey, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.