Individual provider Active NPI

Thomas G Smith, M.D.

  • Family Medicine Physician
  • Cadillac, MI
National Provider Identifier
1245238989
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TS048898 Issued in MI
Practice address
8950 Professional Dr
Cadillac, MI 49601-8599
Phone
(231) 775-2493
Fax
(231) 779-7701
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TS048898 MI Primary

Addresses

Primary practice location

8950 Professional Dr
Cadillac, MI 49601-8599

Mailing address

8950 Professional Dr
Cadillac, MI 49601-8599
Phone (231) 775-2493

Other identifiers 4

IdentifierTypeStateIssuer
080H376070OtherMIGROUP BCBS
0808300031OtherMIINDIVIDUAL BCBS
103493OtherMIPREFERRED CHOICES
2904151MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210610000122 TX Practitioner - Family Practice 3072586437 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TS048898MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Apr 1, 2021 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Apr 1, 2021 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Jan 24, 2022 Accepting new patients

Locations

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1245238989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 PROFESSIONAL DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018599",
            "telephone_number": "231-775-2493",
            "fax_number": "231-775-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 PROFESSIONAL DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018599",
            "telephone_number": "231-775-2493",
            "fax_number": "231-779-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "THOMAS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "TS048898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BCBS",
            "identifier": "080H376070",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BCBS",
            "identifier": "0808300031",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICES",
            "identifier": "103493",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2904151",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

Verify at the official NPI Registry.