Individual provider Active NPI

Robert C Smith, M.D.

  • Internal Medicine Physician
  • East Lansing, MI
National Provider Identifier
1194823534
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301049026 Issued in MI
Practice address
138 Service Rd
Suite A225
East Lansing, MI 48824-1376
Phone
(517) 353-4941
Fax
(517) 432-3145
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301049026 MI Primary

Addresses

Primary practice location

138 Service Rd
Suite A225
East Lansing, MI 48824-1376

Mailing address

B338 Clinical Center
Department of Medicine
East Lansing, MI 48824
Phone (517) 432-9124

Other identifiers 1

IdentifierTypeStateIssuer
1659730MedicaidMI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040323001571 MI Practitioner - Internal Medicine 8426949900 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301049026MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan State University Internal Medicine CurrentSince Jan 1, 2003 Accepting new patients
Michigan State University CurrentSince Jan 1, 2003 Accepting new patients

Locations

138 Service Rd
Ste A225
East Lansing, MI 48824
Phone (517) 353-4941

4650 S Hagadorn Rd
Ste 100
East Lansing, MI 48823
Phone (517) 353-4830

138 Service Rd
East Lansing, MI 48824
Phone (517) 353-3050

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

804 Service Rd
#A109F
East Lansing, MI 48824
Phone (517) 884-2976

1200 E Michigan Ave
Ste 655
Lansing, MI 48912
Phone (517) 267-2460

2727 S Pennsylvania Ave
Lansing, MI 48910
Phone (517) 975-3750

1600 W Grand River Ave
Ste 2
Okemos, MI 48864
Phone (517) 349-6560

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1194823534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "B338 CLINICAL CENTER",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48824",
            "telephone_number": "517-432-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 SERVICE RD",
            "address_2": "SUITE A225",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488241376",
            "telephone_number": "517-353-4941",
            "fax_number": "517-432-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301049026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659730",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.