Active NPI
Provision 2, LLC
- Behavioral Neurology & Neuropsychiatry Physician
- Cullman, AL
National Provider Identifier
1366119802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavioral Neurology & Neuropsychiatry Physician
- Legal business name
- PROVISION 2, LLC
- Doing business as
- Sound Mind TMS Therapy
- Practice address
- 210 Main Ave SW
Cullman, AL 35055-3346 - Phone
- (256) 339-9979
- NPI assigned
- Aug 24, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert Wayne Smith, MD
- Title
- Owner
- Phone
- (256) 339-9979
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 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | |||
| Adult Medicine Physician | 207QA0505X | |||
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | |||
| Behavioral Neurology & Neuropsychiatry Physician | 2084B0040X | Primary | ||
| Psychiatry Physician | 2084P0800X | |||
| Addiction Psychiatry Physician | 2084P0802X | |||
| Geriatric Psychiatry Physician | 2084P0805X |
Addresses
Primary practice location
210 Main Ave SW
Cullman, AL 35055-3346
Mailing address
340 County Road 1635
Cullman, AL 35058
Other names 1
- Sound Mind TMS Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
210 Main Ave SW
Cullman, AL 35055
Phone (256) 339-9979
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Cullman, AL
- NPI 1508937723
-
- Psychiatry Physician
- Cullman, AL
- NPI 1578973954
-
- Family Medicine Physician
- Oneonta, AL
- NPI 1760553978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629763200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1737072000000",
"number": "1366119802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 COUNTY ROAD 1635",
"city": "CULLMAN",
"state": "AL",
"postal_code": "35058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 MAIN AVE SW",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350553346",
"telephone_number": "256-339-9979"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROVISION 2, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-08-24",
"last_updated": "2025-01-17",
"certification_date": "2025-01-17",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "WAYNE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "256-339-9979",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QA0505X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Adult Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084B0040X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
"state": null,
"license": null,
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0802X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0805X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sound Mind TMS Therapy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Sound Mind TMS Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Cullman, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.