NPIMap

Organization Active NPI

Melissa W. Smith, M.D., LLC

  • Obstetrics & Gynecology Physician
  • Slidell, LA
National Provider Identifier
1457522419
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
200355 Issued in LA
Legal business name
MELISSA W. SMITH, M.D., LLC
Practice address
1150 Robert Blvd
Suite 360
Slidell, LA 70458-2004
Phone
(985) 781-4848
Fax
(985) 781-4850
NPI assigned
Mar 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Authorized official

Name
Dr. Melissa Welch Smith, MDNPI 1114118932
Title
Owner/President
Phone
(985) 781-4848

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 200355 LA Primary

Addresses

Primary practice location

1150 Robert Blvd
Suite 360
Slidell, LA 70458-2004

Mailing address

1150 Robert Blvd
Suite 360
Slidell, LA 70458-2004
Phone (985) 781-4848

Other identifiers 5

IdentifierTypeStateIssuer
4N209DE75OtherLAMEDICARE LINK #
DN7783OtherLARAILROAD MEDICARE
1028177MedicaidLA
4356788340OtherLABCBS LA PROVIDER NUMBER
435678834OtherMSBCBS OF MS PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080811000014 LA Part B Supplier - Clinic/Group Practice 4587738489 Receives reassigned benefits from 1 practitioner
Practice locations: Slidell, LA

National Provider Directory

National Provider Directory

Locations

1150 Robert Blvd
Ste 360
Slidell, LA 70458
Phone (985) 781-4848

Practitioners & affiliated clinicians

Practitioners 5

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": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1457522419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 ROBERT BLVD",
            "address_2": "SUITE 360",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582004",
            "telephone_number": "985-781-4848",
            "fax_number": "985-781-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 ROBERT BLVD",
            "address_2": "SUITE 360",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582004",
            "telephone_number": "985-781-4848",
            "fax_number": "985-781-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA W. SMITH, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "WELCH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "985-781-4848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "200355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LINK #",
            "identifier": "4N209DE75",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN7783",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028177",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS LA PROVIDER NUMBER",
            "identifier": "4356788340",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MS PROVIDER NUMBER",
            "identifier": "435678834",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.