NPIMap

Individual provider Active NPI

Rodney Lewis Smith, MD

  • General Practice Physician
  • Gainesville, GA
National Provider Identifier
1144290917
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
018553 Issued in GA
Practice address
725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone
(770) 534-1986
Fax
(770) 297-5645
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 018553 GA
General Practice Physician 208D00000X 018553 GA Primary

Addresses

Primary practice location

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Mailing address

PO Box 658
Gainesville, GA 30503-0658
Phone (770) 718-1122

Other identifiers 8

IdentifierTypeStateIssuer
000270498CMedicaidGA
52158651OtherGABCBS
010036487OtherGARR MEDICARE
10045346OtherGAAMERIGROUP
336487OtherGAWELLCARE
9733397OtherGACIGNA
000679764AMedicaidGA
0100310OtherGAUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081025000151 GA Practitioner - General PracticePractitioner - Pathology 2062500887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Pathology
Education
Medical College of Georgia School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians
Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

655 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3854
Phone (770) 533-6511

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (770) 533-6511

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 219-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.1 of 100Reported as group
Quality
87.6
Promoting interoperability
100
Improvement activities
40
Cost
76.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018553GAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Longstreet Clinic PC CurrentSince Oct 1, 1995 Accepting new patients
Northeast Georgia Community Physicians LLC CurrentSince Feb 1, 2026 Accepting new patients
The Longstreet Clinic, PC Anatomic Pathology & Clinical Pathology CurrentSince Oct 1, 1995 Accepting new patients

Locations

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 297-2200

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

Interoperability endpoints

  • Direct secure messaging: rodney.smith@longstreetclinic.gadirect.net

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
LaurelwoodGainesville, GA, CCN 11S029 Hospital Corporate Director (100%) Feb 1, 2014
New Horizons Lanier ParkGainesville, GA, CCN 115487 Skilled nursing facility Corporate Director Feb 4, 2008
Hospice of NE Ga Medical CenterGainesville, GA, CCN 111514 Hospice Corporate Director Nov 26, 2007

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1144290917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-533-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "770-534-1986",
            "fax_number": "770-297-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RODNEY",
        "middle_name": "LEWIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "018553",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "018553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000270498C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52158651",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "010036487",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10045346",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "336487",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9733397",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000679764A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0100310",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.