Individual provider Active NPI

Laura A. Smiricky, MD

  • Internal Medicine Physician
  • Grants Pass, OR
National Provider Identifier
1245205582
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036097740 Issued in IL
Practice address
500 SW Ramsey Ave
Grants Pass, OR 97527
Phone
(541) 472-7000
Fax
(312) 829-2024
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036097740 IL Primary

Addresses

Primary practice location

500 SW Ramsey Ave
Grants Pass, OR 97527

Mailing address

2620 East Barnett Rd
Suite H
Medford, OR 97504
Phone (541) 789-5250

Other identifiers 1

IdentifierTypeStateIssuer
036097740MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20111005000576 OR Practitioner - Internal Medicine 1052362969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 472-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036097740ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asante Physician Partners Internal Medicine CurrentSince Sep 16, 2016 Accepting new patients

Locations

625 SW Ramsey Ave
Ste A
Grants Pass, OR 97527
Phone (541) 474-5004

2620 E Barnett Rd
Ste H
Medford, OR 97504
Phone (541) 789-4281

Organizations & group practices 1

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.

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1245205582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 EAST BARNETT RD",
            "address_2": "SUITE H",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-789-5250",
            "fax_number": "541-789-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97527",
            "telephone_number": "541-472-7000",
            "fax_number": "312-829-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIRICKY",
        "first_name": "LAURA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036097740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036097740",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.