Individual provider Active NPI

Gary Laurence Smith, M.D.

  • Obstetrics & Gynecology Physician
  • Marietta, GA
National Provider Identifier
1366517500
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
015509 Issued in GA
Practice address
1230 Johnson Ferry Rd
Suite H-30
Marietta, GA 60068
Phone
(770) 565-4224
Fax
(770) 509-0487
NPI assigned
Nov 22, 2006
Last updated
Jul 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 015509 GA Primary

Addresses

Primary practice location

1230 Johnson Ferry Rd
Suite H-30
Marietta, GA 60068

Mailing address

1230 Johnson Ferry Rd
Suite H-30
Marietta, GA 60068
Phone (770) 565-4224

Other identifiers 1

IdentifierTypeStateIssuer
000182069CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015509GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gary L. Smith, MD, PC Obstetrics & Gynecology PastSince Dec 19, 1991 Accepting new patients

Organizations & group practices 1

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1366517500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 JOHNSON FERRY RD",
            "address_2": "SUITE H-30",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "60068",
            "telephone_number": "770-565-4224",
            "fax_number": "770-509-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 JOHNSON FERRY RD",
            "address_2": "SUITE H-30",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "60068",
            "telephone_number": "770-565-4224",
            "fax_number": "770-509-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GARY",
        "middle_name": "LAURENCE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "015509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000182069C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.