Gregory E Smith, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

103971 Issued in NC

Practice address

1905 Skibo Road
Suite 100
Fayetteville, NC 28314-0261

Phone

(910) 864-4357

Fax

(910) 221-0099

NPI assigned

Jan 22, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Whiteville Mat Services, Inc.

  • Methadone Clinic
  • Whiteville, NC
  • NPI 1740868744
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1285788679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 SKIBO RD",
            "address_2": "SUITE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283140260",
            "telephone_number": "910-864-4357",
            "fax_number": "910-221-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 SKIBO ROAD",
            "address_2": "SUITE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283140261",
            "telephone_number": "910-864-4357",
            "fax_number": "910-221-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GREGORY",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "103971",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "145009",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "103971",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deztiny Smith
• Diasha Smith
• Ebony M. Smith, LPN
• Elizabeth Smith, REGISTERED NURSE
• Emmaleigh Madeline Smith
• Gwendolyn Smith
• Harold Smith
• Harold William Smith Jr., PHARM.D.
• Henry Zack Smith, DDS, MS, PA
• Husniya Smith

• Medical Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.