NPIMap

Organization Active NPI

Michael J Smith MD SC

  • Internal Medicine Physician
  • Eau Claire, WI
National Provider Identifier
1336210988
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33571 Issued in WI
Legal business name
MICHAEL J SMITH MD SC
Practice address
714 W Hamilton Ave
Eau Claire, WI 54701-6937
Phone
(715) 830-9990
Fax
(715) 830-9995
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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

Authorized official

Name
Dr. Michael J Smith, M.D.NPI 1740240076
Title
Director President
Phone
(715) 830-9990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 33571 WI Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 33571 WI

Addresses

Primary practice location

714 W Hamilton Ave
Eau Claire, WI 54701-6937

Mailing address

714 W Hamilton Ave
Eau Claire, WI 54701-6937
Phone (715) 830-9990

Other identifiers 1

IdentifierTypeStateIssuer
31849300MedicaidWI

National Provider Directory

National Provider Directory

Locations

714 W Hamilton Ave
Eau Claire, WI 54701
Phone (715) 830-9990

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1336210988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 W HAMILTON AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016937",
            "telephone_number": "715-830-9990",
            "fax_number": "715-830-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W HAMILTON AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016937",
            "telephone_number": "715-830-9990",
            "fax_number": "715-830-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J SMITH MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR PRESIDENT",
        "authorized_official_telephone_number": "715-830-9990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "33571",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "33571",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31849300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.