Individual provider Active NPI

Nicholas James Smith, D.O.

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1215317540
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2016038251 Issued in MO
Practice address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone
(314) 251-6090
NPI assigned
Jun 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2016038251 MO Primary

Addresses

Primary practice location

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Mailing address

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (314) 251-6090

Other practice location 1

1400 US Highway 61
Festus, MO 63028-4100
Phone (636) 933-1111

Other practice location 2

901 E 5th St
Washington, MO 63090-3127
Phone (636) 239-8011

Other practice location 3

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

Other practice location 4

434 N West St
Perryville, MO 63775-1359
Phone (573) 547-2536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20171226000546 MO Practitioner - Emergency Medicine 8921309741 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Philadelphia College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospitals East CommunitiesGroup PAC ID 1658276811, 92 clinicians

Practice addresses (Care Compare)

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (636) 251-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016038251MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Apr 15, 2022 Accepting new patients
Mercy Hospital Jefferson CurrentSince Apr 15, 2022 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Apr 15, 2022 Accepting new patients
Mercy Hospital Perry CurrentSince Dec 19, 2023 Accepting new patients
Mercy Hospital South CurrentSince Apr 15, 2022 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Feb 1, 2018 Accepting new patients
Mercy Hospital Jefferson CurrentSince Apr 15, 2022 Accepting new patients
Mercy Hospitals East Communities CurrentSince Apr 15, 2022 Accepting new patients
University Health Physicians Emergency Medicine CurrentSince Jul 13, 2018 Accepting new patients
St Louis Pathology Assoc Inc. Current Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Apr 15, 2022 Accepting new patients
Mercy Hospital South Emergency Medicine CurrentSince Apr 15, 2022 Accepting new patients
Mercy Hospital Perry Emergency Medicine CurrentSince Dec 19, 2023 Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

4407 E 50th Ter
Kansas City, MO 64130
Phone (816) 924-1201

2301 Holmes St
Kansas City, MO 64108

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Interoperability endpoints

  • Direct secure messaging: nsmith@direct.cmh.edu

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1215317540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 US Highway 61",
            "address_purpose": "LOCATION",
            "city": "Festus",
            "state": "MO",
            "postal_code": "630284100",
            "country_code": "US",
            "telephone_number": "636-933-1111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 E 5th St",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630903127",
            "country_code": "US",
            "telephone_number": "636-239-8011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10010 Kennerly Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "314-525-1906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "434 N West St",
            "address_purpose": "LOCATION",
            "city": "Perryville",
            "state": "MO",
            "postal_code": "637751359",
            "country_code": "US",
            "telephone_number": "573-547-2536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2016038251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.