Individual provider Active NPI

Michele S Smith, PHD

  • Marriage & Family Therapist
  • Morrow, GA
National Provider Identifier
1174782452
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT001178 Issued in GA
Practice address
1000 Corporate Center Dr
Suite 200
Morrow, GA 30260-4180
Phone
(770) 968-6380
Fax
(770) 968-6465
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT001178 GA Primary
Marriage & Family Therapist 106H00000X MFC43092 CA

Addresses

Primary practice location

1000 Corporate Center Dr
Suite 200
Morrow, GA 30260-4180

Mailing address

1000 Corporate Center Dr Ste 200
Morrow, GA 30260-4129
Phone (770) 968-6464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160426001517 GA Practitioner - Clinical Psychologist 6800195835 Reassigns benefits to 1 organization
I20240404000703 GA Practitioner - Marriage and Family Therapist 6800195835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

5150 Stilesboro N W Rd
Kennesaw, GA 30152-7742
Phone (770) 424-8222

6002 Professional Pkwy
Douglasville, GA 30134-5627

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MFC43092CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2016 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2016 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

1000 Corporate Center Dr
Ste 200
Morrow, GA 30260
Phone (770) 968-6464

Interoperability endpoints

  • Direct secure messaging: michele.smith.p52@direct.tenet.nextgenshare.com

Organizations & group practices 3

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1174782452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CORPORATE CENTER DR STE 200",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302604129",
            "telephone_number": "770-968-6464",
            "fax_number": "770-968-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CORPORATE CENTER DR",
            "address_2": "SUITE 200",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302604180",
            "telephone_number": "770-968-6380",
            "fax_number": "770-968-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHELE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001178",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC43092",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

Verify at the official NPI Registry.