Individual provider Active NPI

Tamra L Smith, M.D.

  • Family Medicine Physician
  • Collierville, TN
National Provider Identifier
1336121318
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD0000027302 Issued in TN
Practice address
853 W Poplar Ave
Collierville, TN 38017-2545
Phone
(901) 850-8351
Fax
(901) 861-2064
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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 MD0000027302 TN Primary

Addresses

Primary practice location

853 W Poplar Ave
Collierville, TN 38017-2545

Mailing address

853 W Poplar Ave
Collierville, TN 38017-2545
Phone (901) 850-8351

Other identifiers 1

IdentifierTypeStateIssuer
3096572MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040517001215 TN Practitioner - Family Practice 7719977123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000027302TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Family Medicine Past Accepting new patients
Prohealth Chiropractic LLC Past Accepting new patients
Memphis Urgent Care #2, LLC. Family Medicine PastSince Feb 14, 2021 Accepting new patients
Oak Street Health Physicians Group of Tennessee, PLLC Family Medicine PastSince Jul 17, 2022 Accepting new patients

Organizations & group practices 4

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1336121318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 W POPLAR AVE",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172545",
            "telephone_number": "901-850-8351",
            "fax_number": "901-861-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 W POPLAR AVE",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172545",
            "telephone_number": "901-850-8351",
            "fax_number": "901-861-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TAMRA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000027302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3096572",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

Verify at the official NPI Registry.