Individual provider Active NPI

Glenda Ruth Smith, MD

  • Radiation Oncology Physician
  • Vineland, NJ
National Provider Identifier
1477554418
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MA07048300 Issued in NJ
Practice address
1505 W. Sherman Ave.
Radiation Oncology
Vineland, NJ 08360-6912
Phone
(856) 641-7920
Fax
(856) 641-7915
NPI assigned
Aug 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MA07048300 NJ Primary

Addresses

Primary practice location

1505 W. Sherman Ave.
Radiation Oncology
Vineland, NJ 08360-6912

Mailing address

1505 W. Sherman Ave.
Radiation Oncology
Vineland, NJ 08360-6912
Phone (856) 641-7920

Other identifiers 1

IdentifierTypeStateIssuer
4626206MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050722000193 NJ Practitioner - Radiation Oncology 5890722797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Howard University College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

798 Centerton Rd
Pittsgrove, NJ 08318-3945
Phone (856) 358-6161

Hospital & facility affiliations

  • Inspira Medical Center Vineland Hospital, Vineland, NJ, CCN 310032
  • Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA07048300NJMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Health Network Medical Group, P.C. CurrentSince Nov 30, 2023 Accepting new patients
Tri-County Health Connections PC Past Accepting new patients

Locations

798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

1505 W Sherman Ave
Ste 112
Vineland, NJ 08360
Phone (856) 641-7920

Organizations & group practices 2

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 4

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": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265587200000",
    "number": "1477554418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W. SHERMAN AVE.",
            "address_2": "RADIATION ONCOLOGY",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606912",
            "telephone_number": "856-641-7920",
            "fax_number": "856-641-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W. SHERMAN AVE.",
            "address_2": "RADIATION ONCOLOGY",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606912",
            "telephone_number": "856-641-7920",
            "fax_number": "856-641-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GLENDA",
        "middle_name": "RUTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-01",
        "last_updated": "2010-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NJ",
            "license": "MA07048300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4626206",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.