Douglas Parker Smith, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2004005782 Issued in MO

Practice address

516 W McCord St
Neosho, MO 64850-1424

Phone

(417) 451-0977

NPI assigned

Aug 31, 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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1174634489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 COUNTRY BLUFF DR",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656168848",
            "telephone_number": "417-230-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W MCCORD ST",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501424",
            "telephone_number": "417-451-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DOUGLAS",
        "middle_name": "PARKER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2004005782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400568002",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lewis David Shuler, DO
• Michael Shurley, O.D.
• Michelle Lea Sledge, MS, CCC-SLP
• Ashden Nichole Smith, FNP-C
• Brian L Smith, DO
• Michael Christopher Smith, RPH
• Southwest Missouri Counseling
• Southwest Support Services, Inc.
• Reona Kenai Sowers, MD
• Megan Spaunhorst

• General Practice Dentistry in Neosho, MO
• Providers in Neosho, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.