Melissa Lyn Smith

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

64111 Issued in TN

Practice address

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7457

Phone

(205) 348-1770

Fax

(205) 348-1772

NPI assigned

Apr 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Chattanooga Emergency Medicine PLLC

  • Emergency Care Clinic/Center
  • Hixson, TN
  • NPI 1427264126
  Medicare reassignment NPD
• Emergency Medical Care Facilities PC

  • Emergency Medicine Physician
  • Jackson, TN
  • NPI 1538345855
  Medicare reassignment NPD
• Chattanooga Emergency Medicine PLLC

  • Emergency Care Clinic/Center
  • Chattanooga, TN
  • NPI 1174739908

  GA

  Medicare reassignment

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1265939573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017457",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELISSA",
        "middle_name": "LYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "64111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Elizabeth Smith, PHARMD
• Marilyn Dyer Smith
• Mark W Smith, DC
• Mary Catherine Smith
• Mary D Smith, MSW, LICSW
• Micah Danille Smith
• Nachasity Marie Smith, CRNP
• Rashida Smith, CRNP
• Sandra C Smith
• Shannon Brantley Smith, CRNP

• Family Medicine Physician in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.