Paul Gordon Smith, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

4301040968 Issued in MI

Practice address

5333 McAuley Drive
Suite 4003
Ypsilanti, MI 48197-1099

Phone

(734) 712-3470

Fax

(734) 712-2935

NPI assigned

Mar 24, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Michigan Multispecialty Physicians, P.C.

  • Critical Care Medicine (Internal Medicine) Physician
  • Ypsilanti, MI
  • NPI 1912941337

  Nephrology

  NPD (past)
• Renal Treatment Centers-Illinois, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chicago, IL
  • NPI 1396216206
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1174583173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DRIVE",
            "address_2": "SUITE 4003",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971099",
            "telephone_number": "734-712-3470",
            "fax_number": "734-712-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DRIVE",
            "address_2": "SUITE 4003",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971099",
            "telephone_number": "734-712-3470",
            "fax_number": "734-712-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAUL",
        "middle_name": "GORDON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301040968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4261954-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kruz Smith
• Madison Marie Smith, MA, IBCLC
• McKenna Marie Smith
• Michael Washburn Smith, MD
• Naomi Tyrese Smith, LMSW, LCSW
• Robbyn Deborah-Renee Smith, FNP-C
• Rodney W Smith, MD
• Samria Smith
• Shakyra Dalisha Smith
• Shelly Renee Smith, RN

• Nephrology Physician in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Nephrology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.