Individual provider Active NPI

Benjamin Wilson Smith III, D.C.

  • Chiropractor
  • Hoover, AL
National Provider Identifier
1306996657
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2096 Issued in AL
Practice address
1801 Doug Baker Blvd Ste 115
Hoover, AL 35242-4958
Phone
(205) 536-7758
Fax
(205) 536-7759
NPI assigned
Jan 11, 2007
Last updated
Nov 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2096 AL Primary

Addresses

Primary practice location

1801 Doug Baker Blvd Ste 115
Hoover, AL 35242-4958

Mailing address

1801 Doug Baker Blvd Ste 115
Hoover, AL 35242-4958
Phone (205) 536-7758

Other identifiers 6

IdentifierTypeStateIssuer
668275OtherALACN GROUP AND UNITED
51529981OtherALBLUE CROSS BLUE SHIELD
7952010OtherALCIGNA
11495142OtherALCAQH
7002756OtherALAETNA
0083035OtherALHEALTH SPRING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406000806 AL Practitioner - Chiropractic 8022065598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1801 Doug Baker Blvd
Suite 115
Hoover, AL 35242-4958
Phone (205) 536-7758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2096ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benjamin Enterprises, Inc Chiropractor CurrentSince Aug 1, 2007 Accepting new patients
Walch Chiropractic Center Chiropractor Past Accepting new patients
Kinetic Physical Therapy, LLC PastSince Aug 30, 2020 Accepting new patients

Locations

15582 Highway 280
Ste 114
Chelsea, AL 35043
Phone (205) 678-6884

1801 Doug Baker Blvd
Hoover, AL 35242
Phone (205) 536-7758

1801 Doug Baker Blvd
Ste 115
Hoover, AL 35242
Phone (205) 536-7758

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1306996657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 DOUG BAKER BLVD STE 115",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352424958",
            "telephone_number": "205-536-7758",
            "fax_number": "205-536-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 DOUG BAKER BLVD STE 115",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352424958",
            "telephone_number": "205-536-7758",
            "fax_number": "205-536-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP AND UNITED",
            "identifier": "668275",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51529981",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7952010",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11495142",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7002756",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH SPRING",
            "identifier": "0083035",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.