Organization Active NPI

Arnold Graham Smith, MD PA

  • Specialist
  • Jacksonville, FL
National Provider Identifier
1386985307
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0039103 Issued in FL
Legal business name
ARNOLD GRAHAM SMITH, MD PA
Practice address
9191 R G Skinner Pkwy
Suite 103
Jacksonville, FL 32256-9655
Phone
(904) 391-6862
Fax
(904) 391-1005
NPI assigned
Mar 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Authorized official

Name
Ms. Shannon Goossen
Title
Admin/VP
Phone
(904) 391-6862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME0039103 FL Primary

Addresses

Primary practice location

9191 R G Skinner Pkwy
Suite 103
Jacksonville, FL 32256-9655

Mailing address

9191 R G Skinner Pkwy
Suite 103
Jacksonville, FL 32256-9655
Phone (904) 391-6862

Other identifiers 1

IdentifierTypeStateIssuer
15651OtherBCBS PROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

14546 Old St Augustine Rd
Ste 403
Jacksonville, FL 32258
Phone (904) 296-1500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1386985307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 R G SKINNER PKWY",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569655",
            "telephone_number": "904-391-6862",
            "fax_number": "904-391-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 R G SKINNER PKWY",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569655",
            "telephone_number": "904-391-6862",
            "fax_number": "904-391-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARNOLD GRAHAM SMITH, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-15",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "GOOSSEN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "ADMIN/VP",
        "authorized_official_telephone_number": "904-391-6862",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0039103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "15651",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.