Individual provider Active NPI

Nicholas Brett Smith, MD

  • Family Medicine Physician
  • Georgetown, KY
National Provider Identifier
1194777953
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40228 Issued in KY
Practice address
1502 Oxford Dr Ste 100
Georgetown, KY 40324-8096
Phone
(502) 570-3785
NPI assigned
May 17, 2006
Last updated
Jun 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45319 TN
Family Medicine Physician 207Q00000X 0101253346 VA
Family Medicine Physician 207Q00000X 40228 KY Primary

Addresses

Primary practice location

1502 Oxford Dr Ste 100
Georgetown, KY 40324-8096

Mailing address

4600 Fort Henry Dr
Kingsport, TN 37663
Phone (423) 224-3950

Other practice location 1

4600 Fort Henry Dr
Kingsport, TN 37663
Phone (423) 224-3950

Other identifiers 3

IdentifierTypeStateIssuer
P01758949OtherTNRAILROAD MEDICARE
1194777953MedicaidVA
1515572MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070622000556 KY Practitioner - Family Practice 4284733825 Reassigns benefits to 1 organization
I20091028000032 TN Practitioner - Family Practice 4284733825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Mso LLCGroup PAC ID 0749450633, 53 clinicians

Practice addresses (Care Compare)

1502 Oxford Dr
Suite 100
Georgetown, KY 40324-8096
Phone (502) 570-3785

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40228KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Kentucky Mso LLC Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Mar 22, 2022 Accepting new patients
Kentucky Mso LLC CurrentSince Jul 15, 2023 Accepting new patients
Blue Ridge Medical Managgement Corporation CurrentSince Feb 19, 2019 Accepting new patients
Wellmont Medical Associates Inc Family Medicine CurrentSince Mar 22, 2022 Accepting new patients
Kentucky Mso LLC CurrentSince Jul 15, 2023 Accepting new patients
Blue Ridge Medical Management Corporation Family Medicine CurrentSince Feb 19, 2019 Accepting new patients
The Medical Center at Franklin ER Physicians Past Accepting new patients
Kentucky Mso LLC Past Accepting new patients

Locations

105 Prather Path
Ste 1200
Georgetown, KY 40324
Phone (502) 570-3785

1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100

1140 Lexington Rd
Ste 105
Georgetown, KY 40324
Phone (502) 868-5660

1502 Oxford Dr
Ste 100
Georgetown, KY 40324
Phone (502) 570-3785

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

1497 W Elk Ave
Ste 11
Elizabethton, TN 37643
Phone (423) 542-7480

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

314 Rogosin Dr
Elizabethton, TN 37643
Phone (423) 433-6630

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867

395 Forest Cir
Ste 100
Jonesborough, TN 37659
Phone (423) 753-0721

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

4600 Fort Henry Dr
Kingsport, TN 37663
Phone (423) 224-3950

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

603 Campus Dr
#100
Abingdon, VA 24210
Phone (276) 628-4406

Interoperability endpoints

  • Direct secure messaging: nicholas.smith.1@19475.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1194777953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 FORT HENRY DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37663",
            "telephone_number": "423-224-3950",
            "fax_number": "423-224-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 OXFORD DR STE 100",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248096",
            "telephone_number": "502-570-3785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Fort Henry Dr",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "37663",
            "country_code": "US",
            "telephone_number": "423-224-3950",
            "fax_number": "423-224-3959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLAS",
        "middle_name": "BRETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "45319",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101253346",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "40228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01758949",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194777953",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515572",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.