Stephen Michael Smith, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

11623 Issued in WV

Practice address

11 N Locust St
Buckhannon, WV 26201-2231

Phone

(304) 472-1600

Fax

(304) 472-6055

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1467463950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2630",
            "address_2": "CENTRAL WV MEDCORP INC",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262412630",
            "telephone_number": "304-637-3799",
            "fax_number": "304-637-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 N LOCUST ST",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012231",
            "telephone_number": "304-472-1600",
            "fax_number": "304-472-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "11623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083382000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN",
            "identifier": "WV11623B",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "11623",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BCBS NUMBER",
            "identifier": "000159893",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlynn Smith
• Mariah Taylor Marie Smith, RN
• Melinda Louise Smith
• Misty Smith
• Rhonda Smith
• Tammy Smith
• Wesley Alan Smith, PSY.D.
• Crystal Dawn Smithson, ED.S.
• Tamara Neal Smithson, MA ED CCC/SLP
• Donna Jo Snider

• Internal Medicine Physician in Buckhannon, WV
• Providers in Buckhannon, WV by specialty
• Internal Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.