Active NPI
Charles Burrell Smith Jr., D.C.
- Chiropractor
- Dardanelle, AR
National Provider Identifier
1427192707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1626
- Practice address
- 507 N 2ND St
Dardanelle, AR 72834-3533 - Phone
- (479) 229-0332
- Fax
- (479) 229-0465
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1626 | AR | Primary |
Addresses
Primary practice location
507 N 2ND St
Dardanelle, AR 72834-3533
Mailing address
507 N 2ND St
Dardanelle, AR 72834-3533
Phone (479) 229-0332
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5Y299 | Other | AR | BLUE CROSS BLUE SHIELD |
| 040325 | Other | AR | UNITED HEALTH CARE |
| 7017685 | Other | AR | AETNA |
| 500114 | Other | AR | NOVASYS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1626 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427192707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 N 2ND ST",
"city": "DARDANELLE",
"state": "AR",
"postal_code": "728343533",
"telephone_number": "479-229-0332",
"fax_number": "479-229-0465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 N 2ND ST",
"city": "DARDANELLE",
"state": "AR",
"postal_code": "728343533",
"telephone_number": "479-229-0332",
"fax_number": "479-229-0465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "CHARLES",
"middle_name": "BURRELL",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "1626",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5Y299",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "040325",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7017685",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NOVASYS",
"identifier": "500114",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dardanelle, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.