Individual provider Active NPI

Jeffrey W. Smith II, D.O.

  • Nephrology Physician
  • Sumter, SC
National Provider Identifier
1376636969
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
791 Issued in SC
Practice address
3 Medical CT
Sumter, SC 29150-4760
Phone
(803) 938-5663
Fax
(803) 938-5088
NPI assigned
Oct 2, 2006
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 791 SC Primary

Addresses

Primary practice location

3 Medical CT
Sumter, SC 29150-4760

Mailing address

115 N Sumter St
305
Sumter, SC 29150-4972
Phone (803) 938-5663

Other identifiers 1

IdentifierTypeStateIssuer
007913MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040625000887 SC Practitioner - Internal MedicinePractitioner - Nephrology 8729064266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 Medical CT
Sumter, SC 29150-4760
Phone (803) 938-5663

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
791SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
M Francisco Gonzalez, MD, PA CurrentSince Jun 2, 2013 Accepting new patients
Sumter Nephrology LLC Nephrology CurrentSince Mar 25, 2013 Accepting new patients

Locations

115 N Sumter St
Ste 305
Sumter, SC 29150
Phone (803) 934-8348

115 N Sumter St
Ste 400
Sumter, SC 29150
Phone (803) 774-7425

3 Medical Ct
Sumter, SC 29150
Phone (803) 934-8348

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1376636969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N SUMTER ST",
            "address_2": "305",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504972",
            "telephone_number": "803-938-5663",
            "fax_number": "803-339-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL CT",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504760",
            "telephone_number": "803-938-5663",
            "fax_number": "803-938-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEFFREY",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007913",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.