Organization Active NPI

Valerie C Smart MD PA

  • Internal Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1427067412
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME76184 Issued in FL
Legal business name
VALERIE C SMART MD PA
Practice address
6371 Presidential CT
Ste 2
Fort Myers, FL 33919
Phone
(239) 277-7747
Fax
(239) 277-7097
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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

Authorized official

Name
Valerie C Smart, MDNPI 1902061401
Title
President
Phone
(239) 277-7747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME76184 FL Primary

Addresses

Primary practice location

6371 Presidential CT
Ste 2
Fort Myers, FL 33919

Mailing address

6371 Presidential CT
Ste 2
Fort Myers, FL 33919
Phone (239) 277-7747

Other identifiers 1

IdentifierTypeStateIssuer
001295400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130225000225 FL Part B Supplier - Clinic/Group Practice 3870748825 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

6371 Presidential Ct
Ste 2
Fort Myers, FL 33919
Phone (239) 277-7747

Practitioners & affiliated clinicians

Practitioners 2

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": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325808000000",
    "number": "1427067412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6371 PRESIDENTIAL CT",
            "address_2": "STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33919",
            "telephone_number": "239-277-7747",
            "fax_number": "239-277-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6371 PRESIDENTIAL CT",
            "address_2": "STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33919",
            "telephone_number": "239-277-7747",
            "fax_number": "239-277-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALERIE C SMART MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2012-01-06",
        "status": "A",
        "authorized_official_last_name": "SMART",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-277-7747",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME76184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001295400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.