Amy Ann Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085005048 Issued in IL

Practice address

550 Southland Dr
Decatur, IL 62521-4080

Phone

(217) 425-9264

Fax

(217) 425-5983

NPI assigned

Oct 12, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Amy Ann Davis Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Mid West Medical College, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Decatur Memorial HospitalGroup PAC ID 6204731144, 173 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135

Merit-based Incentive Payment System (MIPS)

Final score

73.88 of 100Reported as group

Quality

63.91

Improvement activities

40

Cost

77.03

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amysmith@memorial.allscriptsdirect.net
• Direct secure messaging: amysmith@sfc.allscriptsdirect.net

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.

• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725
  Medicare reassignment Care Compare group NPD
• Memorial Health Partners

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1376034744
  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Estrella Internal Medicine and Pediatrics PC

  • Internal Medicine Physician
  • Goodyear, AZ
  • NPI 1669426565
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1548357973
  Care Compare affiliation

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1174875223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "address_2": "GSBLL",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-2857",
            "fax_number": "217-876-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SOUTHLAND DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625214080",
            "telephone_number": "217-425-9264",
            "fax_number": "217-425-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-12",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085005048",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5214",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "DAVIS",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica L Smiley, LCSW
• Smith Hearing Technologies, LLC
• Abigail Smith
• Addie L Smith, LSW
• Amy Smith, M.S.
• Andrea Lynne Smith, LSW
• Annie Michele Smith, L.C.S.W.
• Daniel Burtion Smith, M.D.
• Elizabeth K Smith, LPN
• Eric Smith, HIS

• Physician Assistant in Decatur, IL
• Providers in Decatur, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.