Individual provider Active NPI

Ronald Kent Smith III, PA-C

  • Physician Assistant
  • Fort Bliss, TX
National Provider Identifier
1184035305
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5005 N. Piedras
Wbamc
Fort Bliss, TX 79920
Phone
(915) 742-4432
NPI assigned
May 9, 2014
Last updated
Oct 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

5005 N. Piedras
Wbamc
Fort Bliss, TX 79920

Mailing address

1814 S Cedar St
Imlay City, MI 48444-9779
Phone (810) 721-7476

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180920002487 MI Practitioner - Physician Assistant 9335490945 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Medical Center CurrentSince Mar 6, 2019 Accepting new patients
Hurley Medical Center Current Accepting new patients
Hurley Medical Center CurrentSince Mar 6, 2019 Accepting new patients
Hurley Medical Center Physician Assistant Current Accepting new patients
Hurley Medical Center Physician Assistant CurrentSince Mar 6, 2019 Accepting new patients
Pathology Associates Inc PC Current Accepting new patients
Hurley Medical Center Current Accepting new patients

Locations

4272 W Vienna Rd
Clio, MI 48420
Phone (810) 687-2850

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

1125 S Linden Rd
Ste 210
Flint, MI 48532
Phone (810) 230-3370

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1184035305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 S CEDAR ST",
            "city": "IMLAY CITY",
            "state": "MI",
            "postal_code": "484449779",
            "telephone_number": "810-721-7476",
            "fax_number": "810-721-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 N. PIEDRAS",
            "address_2": "WBAMC",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "79920",
            "telephone_number": "915-742-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RONALD",
        "middle_name": "KENT",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-09",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bliss, TX

Sources for this page

Verify at the official NPI Registry.