Individual provider Active NPI

Brent Austin Smoyer, PA-C

  • Physician Assistant
  • Southaven, MS
National Provider Identifier
1457647414
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00167 Issued in MS
Practice address
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone
(731) 514-1824
NPI assigned
Jun 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1987 TN
Surgical Physician Assistant 363AS0400X 2011024428 MO
Physician Assistant 363A00000X PA00167 MS Primary

Addresses

Primary practice location

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Mailing address

4400 Fairmeadow Rd
Memphis, TN 38117-6024
Phone (731) 514-1824

Other practice location 1

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AR, TN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20120829000041 MS Practitioner - Physician Assistant 6002073426 Reassigns benefits to 1 organization
I20220316004119 AR Practitioner - Physician Assistant 6002073426 Reassigns benefits to 1 organization
I20240228002876 TN Practitioner - Physician Assistant 6002073426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians

Practice addresses (Care Compare)

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-8336

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00167MSMDPhysician Assistant
1987TNMDPhysician Assistant
2011024428MOMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Regional One Physicians Inc Physician Assistant CurrentSince Aug 17, 2025 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Aug 17, 2025 Accepting new patients

Locations

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

Interoperability endpoints

  • Direct secure messaging: bsmoyer33040@direct.bmhcc.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1457647414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 FAIRMEADOW RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381176024",
            "telephone_number": "731-514-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "731-514-1824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "877 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032807",
            "country_code": "US",
            "telephone_number": "901-545-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMOYER",
        "first_name": "BRENT",
        "middle_name": "AUSTIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-28",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1987",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2011024428",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.