Cristie Lynn Smith, CERTIFIED MEDICAL AS

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

119 Gas Plant Rd
Rea Clinic Du Quoin
Du Quoin, IL 62832

Phone

(618) 724-8702

Fax

(618) 724-2571

NPI assigned

Oct 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Cristie Lynn Pfeiffer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Science

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235226069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "address_2": "REA CLINIC",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "62832",
            "telephone_number": "618-724-2401",
            "fax_number": "618-724-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 GAS PLANT RD",
            "address_2": "REA CLINIC DU QUOIN",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "62832",
            "telephone_number": "618-724-8702",
            "fax_number": "618-724-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CRISTIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CERTIFIED MEDICAL AS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTIE",
            "last_name": "PFEIFFER",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "CERTIFIED MEDICAL AS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandra Schubert
• Emily Schwengel, O.D.
• Estefana Huerta Shaviss
• Angela Jane Shaw, LPN
• Charelle Octavia Smith, MD
• Southern Illinois Eyecare PLLC (DuQuoin Eyecare)
• Southern Illinois Surgical Appliance Co (SISA Home Medical)
• Lela Spiller-Copeland, MHP
• Haley Stanton
• Renee Strauss, QMHP

• Medical Physician Assistant in Du Quoin, IL
• Providers in Du Quoin, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.