Individual provider Active NPI

William D Smith, MD

  • Anesthesiology Physician
  • Bristol, TN
National Provider Identifier
1205865540
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
016915 Issued in TN
Practice address
2223 Edgemont Ave
Bristol, TN 37620-4726
Phone
(423) 646-7472
NPI assigned
Jun 30, 2006
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 016915 TN Primary

Addresses

Primary practice location

2223 Edgemont Ave
Bristol, TN 37620-4726

Mailing address

2223 Edgemont Ave
Bristol, TN 37620-4726
Phone (423) 646-7472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, WV2 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
I20111114000230 TN Practitioner - Anesthesiology 1850565680 Reassigns benefits to 1 organization
I20250321002760 WV Practitioner - Anesthesiology 1850565680 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016915TNMDAnesthesiology Physician
16915TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Anesthesia PC Anesthesiology CurrentSince Mar 11, 1986 Accepting new patients
Camc Greenbrier Valley Medical Center Inc Anesthesiology CurrentSince Apr 1, 2025 Accepting new patients
Camc Greenbrier Valley Medical Center, Inc. CurrentSince Apr 1, 2025 Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Mar 11, 1986 Accepting new patients
Southeastern Pain Management Center, PLLC Past Accepting new patients
Camc Greenbrier Valley Medical Center, Inc. Past Accepting new patients

Locations

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

3185 W State St
Bristol, TN 37620
Phone (423) 968-4141

350 Blountville Hwy
Ste 108
Bristol, TN 37620
Phone (423) 844-6120

350 Blountville Hwy
Ste 207
Bristol, TN 37620
Phone (423) 968-2772

10415 Wallace Alley St
Kingsport, TN 37663
Phone 4233900451 ext. 00451

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

1521 Maplewood Ave
Ronceverte, WV 24970

Organizations & group practices 6

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1205865540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 EDGEMONT AVE",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204726",
            "telephone_number": "423-646-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 EDGEMONT AVE",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204726",
            "telephone_number": "423-646-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILLIAM",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "016915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.