Individual provider Active NPI

Lionel Joe Smith, MD

  • Family Medicine Physician
  • Keokuk, IA
National Provider Identifier
1386617249
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-44053 Issued in IA
Practice address
1603 Morgan St
Suite 3
Keokuk, IA 52632-3430
Phone
(217) 222-6550
NPI assigned
Feb 10, 2006
Last updated
Feb 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036101588 IL
Family Medicine Physician 207Q00000X MD-44053 IA Primary

Addresses

Primary practice location

1603 Morgan St
Suite 3
Keokuk, IA 52632-3430

Mailing address

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

Other identifiers 1

IdentifierTypeStateIssuer
036101588MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20101105001330 IL Practitioner - Family Practice 9638364474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

671 Wabash Ave
Carthage, IL 62321-1443
Phone (217) 357-2171

671 Wabash Ave PO Box
Suite 357
Carthage, IL 62321-0357

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hancock County Health Department CurrentSince Aug 11, 2012 Accepting new patients
Castleview Hospital, LLC Past Accepting new patients
Castleview Physician Practices, LLC Family Medicine Past Accepting new patients

Locations

671 Wabash Ave
Carthage, IL 62321
Phone (217) 357-2171

Organizations & group practices 3

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1386617249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 MORGAN ST",
            "address_2": "SUITE 3",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526323430",
            "telephone_number": "217-222-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LIONEL",
        "middle_name": "JOE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036101588",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-44053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101588",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keokuk, IA

Sources for this page

Verify at the official NPI Registry.