Individual provider Active NPI

Stephen M Smith, M.D.

  • Family Medicine Physician
  • Escanaba, MI
National Provider Identifier
1477965127
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301116709 Issued in MI
Practice address
3409 Ludington Street
Suite 203
Escanaba, MI 49829
Phone
(906) 789-4427
Fax
(906) 789-4446
NPI assigned
May 29, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X L4017R AL
Family Medicine Physician 207Q00000X MD36208 AL
Family Medicine Physician 207Q00000X 4301116709 MI Primary

Addresses

Primary practice location

3409 Ludington Street
Suite 203
Escanaba, MI 49829

Mailing address

3409 Ludington Street
Suite 203
Escanaba, MI 49829
Phone (906) 789-4427

Other practice location 1

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419
Phone (205) 348-1770

Other practice location 2

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419
Phone (205) 348-1770

Other practice location 3

150 Gilbreath Dr
Oneonta, AL 35121-2827
Phone (205) 838-5286

Other identifiers 1

IdentifierTypeStateIssuer
1477965127MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171101001857 AL Practitioner - Family Practice 4880816016 Reassigns benefits to 1 organization
I20190110002497 MI Practitioner - Family Practice 4880816016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis HospitalGroup PAC ID 5991604753, 85 clinicians

Practice addresses (Care Compare)

3409 Ludington St
Escanaba, MI 49829-4213

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L4017RALMDFamily Medicine Physician
MD36208ALMDFamily Medicine Physician
4301116709MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Family Care, LLC Family Medicine CurrentSince Jan 6, 2018 Accepting new patients
St. Francis Hospital Family Medicine CurrentSince Jan 7, 2019 Accepting new patients
American Family Care, LLC CurrentSince Jan 6, 2018 Accepting new patients
St. Francis Hospital Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Apr 1, 2021 Accepting new patients
St Francis Hospital CurrentSince Jan 7, 2019 Accepting new patients
St Francis Hospital Past Accepting new patients

Locations

8151 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 882-9711

2525 5th Ave S
Escanaba, MI 49829
Phone (906) 233-4276

3409 Ludington St
Ste 104
Escanaba, MI 49829
Phone (906) 786-8343

3409 Ludington St
Ste 200
Escanaba, MI 49829
Phone (906) 786-7600

3409 Ludington St
Ste 203
Escanaba, MI 49829
Phone (906) 428-5403

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Osf Bay de Noc HospiceEscanaba, MI, CCN 231563 Hospice Contracted Managing Employee Jul 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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

Hospital & facility affiliations 3

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477965127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 LUDINGTON STREET",
            "address_2": "SUITE 203",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "49829",
            "telephone_number": "906-789-4427",
            "fax_number": "906-789-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 LUDINGTON STREET",
            "address_2": "SUITE 203",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "49829",
            "telephone_number": "906-789-4427",
            "fax_number": "906-789-4446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 Peter Bryce Blvd",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354017419",
            "country_code": "US",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-5294",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 Peter Bryce Blvd",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354017419",
            "country_code": "US",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-5294",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Gilbreath Dr",
            "address_purpose": "LOCATION",
            "city": "Oneonta",
            "state": "AL",
            "postal_code": "351212827",
            "country_code": "US",
            "telephone_number": "205-838-5286",
            "fax_number": "205-838-6119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-29",
        "last_updated": "2022-07-21",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "L4017R",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD36208",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301116709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477965127",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

Verify at the official NPI Registry.