Individual provider Active NPI

Christopher Smith, PSY. D.

  • Clinical Psychologist
  • Sanford, FL
National Provider Identifier
1417272121
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY8387 Issued in FL
Practice address
175 River Oaks Cir
Sanford, FL 32771-9321
Phone
(407) 795-3219
NPI assigned
Apr 6, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY8387 FL Primary

Addresses

Primary practice location

175 River Oaks Cir
Sanford, FL 32771-9321

Mailing address

175 River Oaks Cir
Sanford, FL 32771-9321
Phone (407) 795-3219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY8387FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Azalea Health Services CurrentSince Aug 24, 2023 Accepting new patients
Azalea Health Services Texas LLC CurrentSince Aug 1, 2024 Accepting new patients
Christopher Smith, Psy.D., LLC. PastSince Dec 27, 2011 Accepting new patients
Robert R. Mauger, O.D., P.a. Past Accepting new patients
Inpatient Consultants of Florida Inc Past Accepting new patients

Organizations & group practices 6

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": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1417272121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 RIVER OAKS CIR",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327719321",
            "telephone_number": "407-795-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 RIVER OAKS CIR",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327719321",
            "telephone_number": "407-795-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-06",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

Verify at the official NPI Registry.