Individual provider Active NPI

Mark Alan Smith, MD

  • Internal Medicine Physician
  • Sherwood, AR
National Provider Identifier
1174529887
Registry record updated Aug 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E4293 Issued in AR
Practice address
100 Shadow Oaks Dr
Sherwood, AR 72120-6046
Phone
(501) 681-6181
Fax
(501) 983-4376
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E4293 AR Primary

Addresses

Primary practice location

100 Shadow Oaks Dr
Sherwood, AR 72120-6046

Mailing address

5308 Ridge Rd
Jacksonville, AR 72076-8907
Phone (501) 681-6181

Other practice location 1

5308 Ridge Rd
Jacksonville, AR 72076-8907
Phone (501) 681-6181

Other identifiers 1

IdentifierTypeStateIssuer
155886001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20050209000284 AR Practitioner - Internal Medicine 6305897141 Reassigns benefits to 1 organization
Practice locations: Little Rock, AR; Jacksonville, AR; Heber Springs, AR; Conway, AR; Cabot, AR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E4293ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care 360 CurrentSince Jan 1, 2021 Accepting new patients
Mark Smith Internal Medicine PastSince Oct 5, 2025 Accepting new patients
Physicians Network Inc Dba Cabot Medical Clinic Past Accepting new patients
Arkansas Central Primary Care, PLLC Past Accepting new patients
Physicians Network Inc. Internal Medicine Past Accepting new patients

Locations

100 Shadow Oaks Dr
Sherwood, AR 72120
Phone (501) 918-9192

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
GentivaLittle Rock, AR, CCN 041561 Hospice Contracted Managing Employee Feb 1, 2007

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 5

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786233600000",
    "number": "1174529887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 RIDGE RD",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720768907",
            "telephone_number": "501-681-6181",
            "fax_number": "501-983-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SHADOW OAKS DR",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721206046",
            "telephone_number": "501-681-6181",
            "fax_number": "501-983-4376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5308 Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "AR",
            "postal_code": "720768907",
            "country_code": "US",
            "telephone_number": "501-681-6181",
            "fax_number": "501-983-4376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2026-08-09",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E4293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155886001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, AR

Sources for this page

Verify at the official NPI Registry.