Individual provider Active NPI

Patrick Brent Smith, M.D.

  • Family Medicine Physician
  • Boyle, MS
National Provider Identifier
1205065810
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21265 Issued in MS
Practice address
345 Laughlin Rd
Boyle, MS 38730-8802
Phone
(662) 719-6020
Fax
(662) 725-6250
NPI assigned
Jul 6, 2009
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21265 MS Primary

Addresses

Primary practice location

345 Laughlin Rd
Boyle, MS 38730-8802

Mailing address

803 1St St
Cleveland, MS 38732-2309
Phone (662) 843-2721

Other identifiers 1

IdentifierTypeStateIssuer
05402200MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20110829000710 MS Practitioner - Family PracticePractitioner - Sports Medicine 8628248754 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
University of Mississippi School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Medical GroupGroup PAC ID 6608775531, 48 clinicians

Practice addresses (Care Compare)

1400 E Union St
Greenville, MS 38703-3246
Phone (662) 378-3783

1693 Fairgrounds Rd
Greenville, MS 38703-7810
Phone (662) 378-3783

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
21265MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Sunflower Medical Center CurrentSince Aug 20, 2013 Accepting new patients
South Sunflower County Hospital Current Accepting new patients
Correct Care, Inc. CurrentSince Aug 22, 2024 Accepting new patients
South Sunflower County Hospital CurrentSince Feb 25, 2023 Accepting new patients
South Sunflower County Hospital Current Accepting new patients
South Sunflower County Hospital Current Accepting new patients
North Sunflower Medical Center CurrentSince Aug 20, 2013 Accepting new patients
Delta Medical Group Family Medicine CurrentSince Dec 1, 2022 Accepting new patients
North Sunflower Medical Center Family Medicine Current Accepting new patients
South Sunflower County Hospital CurrentSince Feb 25, 2023 Accepting new patients
Delta Health System Past Accepting new patients
Delta Health System Past Accepting new patients
Delta Physician Practices Past Accepting new patients
Delta Physician Practices Past Accepting new patients

Locations

229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225

1693 Fairgrounds Rd
Greenville, MS 38703
Phone (662) 378-3783

27190 Highway 28
Hazlehurst, MS 39083
Phone (601) 574-7000

121 E Baker St
Indianola, MS 38751
Phone (601) 887-3113

202 S Ruby Ave
Ruleville, MS 38771
Phone (662) 756-2500

840 N Oak Ave
Ruleville, MS 38771
Phone (601) 756-2711

409 Tyler Holmes Dr
Winona, MS 38967
Phone (662) 283-3060

Interoperability endpoints

  • Direct secure messaging: smith_patrick_brent_md@yourcarecommunity.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 7

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": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1205065810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 1ST ST",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322309",
            "telephone_number": "662-843-2721",
            "fax_number": "662-846-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 LAUGHLIN RD",
            "city": "BOYLE",
            "state": "MS",
            "postal_code": "387308802",
            "telephone_number": "662-719-6020",
            "fax_number": "662-725-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PATRICK",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "21265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05402200",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boyle, MS

Sources for this page

Verify at the official NPI Registry.