Active NPI
Norman Brooks Smith, M.D.
- Family Medicine Physician
- San Luis Obispo, CA
National Provider Identifier
1417194408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A20836
- Practice address
- 1 Grand Ave.
Cal Poly Health Services
San Luis Obispo, CA 93407-0210 - Phone
- (805) 756-1211
- Fax
- (805) 756-5298
- NPI assigned
- Jan 13, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A20836 | CA | Primary |
Addresses
Primary practice location
1 Grand Ave.
Cal Poly Health Services
San Luis Obispo, CA 93407-0210
Mailing address
1 Grand Ave.
Cal Poly Health Services
San Luis Obispo, CA 93407-0210
Phone (805) 756-1211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A20836 | Other | CA | CALIFORNIA STATE MEDICAL LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A20836 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231804800000",
"number": "1417194408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GRAND AVE.",
"address_2": "CAL POLY HEALTH SERVICES",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934070210",
"telephone_number": "805-756-1211",
"fax_number": "805-756-5298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GRAND AVE.",
"address_2": "CAL POLY HEALTH SERVICES",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934070210",
"telephone_number": "805-756-1211",
"fax_number": "805-756-5298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "NORMAN",
"middle_name": "BROOKS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-13",
"last_updated": "2009-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A20836",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA STATE MEDICAL LICENSE NUMBER",
"identifier": "A20836",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.