Justin R Smith, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

005694 Issued in GA

Practice address

605 S Enota Dr NE
Gainesville, GA 30501-2437

Phone

(770) 538-0208

Fax

(770) 538-0556

NPI assigned

Oct 19, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

92.21 of 100Reported as group

Quality

100

Improvement activities

40

Cost

74.03

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Lanier Dermatology & Skin Cancer Specialists, PC

  • Dermatology Physician
  • Gainesville, GA
  • NPI 1437109899
  Medicare reassignment

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1376879825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012437",
            "telephone_number": "770-538-0208",
            "fax_number": "770-538-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012437",
            "telephone_number": "770-538-0208",
            "fax_number": "770-538-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUSTIN",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-19",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gergory A Smith, LCSW
• Heather Barclay Smith, APRN
• Jamani Smith
• Jannet Smith
• Jessica Ariel Smith, PT, DPT
• Kevin L Smith, MD
• Kimberly Dawn Smith, MS, OTR/L
• Kristin Nicole Smith, RBT
• Maggie Malaine Smith
• Margie Suzanne Smith, LPC

• Medical Physician Assistant in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.