Individual provider Active NPI

Robert P Smith, MD

  • Family Medicine Physician
  • Richland Center, WI
National Provider Identifier
1255332870
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22826 Issued in WI
Practice address
301 E 2ND St
Richland Center, WI 53581-1900
Phone
(608) 647-6161
Fax
(608) 647-3178
NPI assigned
Aug 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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 22826 WI Primary

Addresses

Primary practice location

301 E 2ND St
Richland Center, WI 53581-1900

Mailing address

301 E 2ND St
Richland Center, WI 53581-1900
Phone (608) 647-6161

Other identifiers 3

IdentifierTypeStateIssuer
528513OtherWIUGS MEDICARE
30303600MedicaidWI
0852480001OtherWIDMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100809000161 WI Practitioner - Family PracticePractitioner - Geriatric Medicine 6002898608

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00000WIMDClinical Social Worker
22826WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Hospital Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Richland Hospital ClinicRichland Center, WI, CCN 528514 Rural health clinic Corporate Director Jan 24, 2023
Spring Green Medical CenterSpring Green, WI, CCN 528655 Rural health clinic Corporate Director Jan 24, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1255332870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E 2ND ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535811900",
            "telephone_number": "608-647-6161",
            "fax_number": "608-647-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 2ND ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535811900",
            "telephone_number": "608-647-6161",
            "fax_number": "608-647-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERT",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "22826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UGS MEDICARE",
            "identifier": "528513",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30303600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0852480001",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland Center, WI

Sources for this page

Verify at the official NPI Registry.