Mark Keith Smith, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G8976 Issued in TX

Practice address

9969 Fredericksburg Rd
San Antonio, TX 78240-4106

Phone

(210) 690-2273

Fax

(210) 581-8209

NPI assigned

Jul 1, 2005

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 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: marksmith@mgmc.allscriptsdirect.net

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1154328433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9969 FREDERICKSBURG RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404106",
            "telephone_number": "210-690-2273",
            "fax_number": "210-581-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9969 FREDERICKSBURG RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404106",
            "telephone_number": "210-690-2273",
            "fax_number": "210-581-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G8976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "85276Y",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUELINK",
            "identifier": "2322005",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255309-04",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "16167-0010",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH",
            "identifier": "873571",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GOLD",
            "identifier": "737803",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO",
            "identifier": "2929822005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA POS",
            "identifier": "2929872004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2044061",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lon S. Smith, M.D.
• Mallory Raye Smith, M.A., BCBA
• Marcella Dawn Smith, RN
• Marina Smith
• Mark B Smith, MD
• Marshall H Smith, M.D.
• Mary Smith
• Megan Smith, LMSW
• Mercedes Smith
• Miaya Smith

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.