Patrick O Smith, P.H.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

32-480 Issued in MS

Practice address

878 Lakeland Dr
Jackson, MS 39216-4644

Phone

(601) 984-6800

Fax

(601) 984-6812

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1225126881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4999",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392964999",
            "telephone_number": "601-984-5410",
            "fax_number": "601-815-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "878 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164644",
            "telephone_number": "601-984-6800",
            "fax_number": "601-984-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PATRICK",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "P.H.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "32-480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03537326",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael P Smith, APRN-CNP
• Michelle Smith, FNP
• Nicholas John Grayson Smith, DO
• Norwood M Smith, M.D.
• Ollie Smith, RN
• Petrina Smith
• Rachel Smith
• Randall S Smith, MD
• Richard Nelson Smith, DMD
• Richard Steven Smith, M.D.

• Clinical Psychologist in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.