Roy A Smith Jr., PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS004266L Issued in PA

Practice address

200 N. 7TH Street
Lebanon, PA 17046-5040

Phone

(717) 272-1653

Fax

(717) 272-4166

NPI assigned

Jul 5, 2005

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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1194722181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N. 7TH STREET",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465040",
            "telephone_number": "717-273-1710",
            "fax_number": "717-273-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N. 7TH STREET",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465040",
            "telephone_number": "717-272-1653",
            "fax_number": "717-272-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS004266L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001511178",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethan Smith, PA-C
• James Smith, C.S.F.A.
• Janice Catherine Smith, MS
• Jessica N Smith, PA-C
• Kaitlyn Grace Smith
• Tracey Smith
• Candace Snavely, B.S.
• Dianne Snavely
• Nicholas Snider
• Sha'Rron Snowden

• Psychologist in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.