Individual provider Active NPI

Peter E Smith, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Stockbridge, GA
National Provider Identifier
1386020832
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD001537 Issued in GA
Practice address
1767 Rock Quarry Rd
Stockbridge, GA 30281-7303
Phone
(770) 474-4395
Fax
(770) 474-7861
NPI assigned
Aug 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC006676 PA
Foot & Ankle Surgery Podiatrist 213ES0103X POD001537 GA Primary

Addresses

Primary practice location

1767 Rock Quarry Rd
Stockbridge, GA 30281-7303

Mailing address

1975 Highway 54 W Ste 205
Peachtree City, GA 30269-4794
Phone (678) 902-0457

Other practice location 1

1380 Milstead Ave NE Ste B
Conyers, GA 30012-3864
Phone (770) 483-1100

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230120000479 GA Practitioner - Podiatry 8527353663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ankle and Foot Centers of Georgia, LLCGroup PAC ID 8022295294, 52 clinicians

Practice addresses (Care Compare)

1767 Rock Quarry Rd
Stockbridge, GA 30281-7303
Phone (770) 474-4395

Hospital & facility affiliations

  • Central Home Health Care, an Amedisys Company Home health agency, Douglasville, GA, CCN 117050
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091

Merit-based Incentive Payment System (MIPS)

Final score
91.6 of 100Reported as group
Quality
88.21
Promoting interoperability
100
Improvement activities
40
Cost
83.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue186
Removal of nail tissue357
Removal or shaving of skin growth143
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006676PAMDPodiatrist
POD001537GAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ankle and Foot Centers of Georgia, LLC Foot & Ankle Surgery CurrentSince Mar 1, 2023 Accepting new patients
Ankle and Foot Centers of Georgia, LLC Podiatrist CurrentSince Mar 1, 2023 Accepting new patients
Ankle and Foot Center of Georgia,LLC Podiatrist Past Accepting new patients
Primehealth of Kentucky LLC Podiatrist Past Accepting new patients

Locations

1380 Milstead Ave NE
Ste B
Conyers, GA 30012
Phone (770) 483-1100

7130 Mount Zion Blvd
Ste 13
Jonesboro, GA 30236
Phone (770) 478-3668

1975 Highway 54 W
Ste 200
Peachtree Cty, GA 30269
Phone (404) 768-3668

1975 Highway 54 W
Ste 205
Peachtree Cty, GA 30269
Phone (678) 561-9000

1767 Rock Quarry Rd
Stockbridge, GA 30281
Phone (770) 474-4395

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1386020832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 HIGHWAY 54 W STE 205",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694794",
            "telephone_number": "678-902-0457",
            "fax_number": "770-415-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1767 ROCK QUARRY RD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817303",
            "telephone_number": "770-474-4395",
            "fax_number": "770-474-7861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1380 Milstead Ave NE Ste B",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300123864",
            "country_code": "US",
            "telephone_number": "770-483-1100",
            "fax_number": "770-483-5855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PETER",
        "middle_name": "E",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-07",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC006676",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.