Active NPI
Paul D Smith, MD
- Surgery Physician
- West Columbia, SC
National Provider Identifier
1154438224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 15723
- Practice address
- 2728 Sunset Blvd Ste 104
West Columbia, SC 29169-4838 - Phone
- (803) 939-2722
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 15723 | SC | Primary |
Addresses
Primary practice location
2728 Sunset Blvd Ste 104
West Columbia, SC 29169-4838
Mailing address
PO Box 896239
Charlotte, NC 28289-6239
Phone (803) 791-2722
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 157234 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15723 | SC | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1154438224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 896239",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282896239",
"telephone_number": "803-791-2722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2728 SUNSET BLVD STE 104",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291694838",
"telephone_number": "803-939-2722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "PAUL",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "15723",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "157234",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.