Active NPI
Justin David Smith, MD
- Emergency Medicine Physician
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 01089817A
- Practice address
- 1701 N Senate Blvd RM Ag012
Indianapolis, IN 46202-1239 - Phone
- (317) 962-5975
- NPI assigned
- Apr 5, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 01089817A | IN | Primary |
Addresses
Primary practice location
1701 N Senate Blvd RM Ag012
Indianapolis, IN 46202-1239
Mailing address
1701 N Senate Blvd RM Ag012
Indianapolis, IN 46202-1239
Phone (317) 962-5975
Other practice location 1
2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9515
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1103692253 | Other | IN | ANTHEM PTAN |
| 300063763 | Medicaid | IN | |
| 264430I01 | Other | IN | MEDICARE PTAN |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jsmith@direct.iuhealth.org | Direct | |
| Direct Messaging Address | jsmith@direct.iuhealth.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1305 N Elm St
Henderson, KY 42420-2783
Phone (270) 827-7100
4011 Gateway Blvd
Newburgh, IN 47630-8947
Phone (812) 450-7299
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01089817A | IN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Health, Inc. | Current | Accepting new patients | |
| Deaconess Hospital, Inc | Emergency Medicine | Current | Accepting new patients |
| Deaconess Hospital Inc | Current | Accepting new patients | |
| Indiana University Health Southern Indiana Physicians LLC | Current | Accepting new patients | |
| Indiana University Health Care Associates, Inc | Current | Accepting new patients | |
| Methodist Health, Inc. | Emergency Medicine | Current | Accepting new patients |
| Deaconess Hospital, Inc | Current | Accepting new patients | |
| Indiana University Health Southern Indiana Physicians, LLC | Emergency Medicine | Current | Accepting new patients |
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients |
Locations
5208 Reliable Pkwy
Chicago, IL 60686
2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147
727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450
600 Mary St
Evansville, IN 47710
Phone (812) 450-2239
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000
4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240
1305 N Elm St
Henderson, KY 42420
Phone (270) 827-7100
Organizations & group practices 9
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.
-
- Hospitalist Physician
- Evansville, IN
- NPI 1427097443
-
- Emergency Medicine Physician
- Henderson, KY
- NPI 1912544958
-
- General Practice Physician
- Indianapolis, IN
- NPI 1902032832
-
- Multi-Specialty Clinic/Center
- Bloomington, IN
- NPI 1013953983
Emergency Medicine
-
- Mental Health Counselor
- Evansville, IN
- NPI 1508723552
-
- Emergency Medicine Physician
- Evansville, IN
- NPI 1922036805
-
- Durable Medical Equipment & Medical Supplies
- Bloomington, IN
- NPI 1063179844
-
- Pain Clinic/Center
- Henderson, KY
- NPI 1780249060
-
- Internal Medicine Physician
- Indianapolis, IN
- NPI 1861441537
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Newburgh, IN
- NPI 1780535427
-
- General Acute Care Hospital
- Evansville, IN
- NPI 1053361642
-
- General Acute Care Hospital
- Henderson, KY
- NPI 1083759633
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1497496459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 N SENATE BLVD RM AG012",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021239",
"telephone_number": "317-962-5975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 N SENATE BLVD RM AG012",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021239",
"telephone_number": "317-962-5975"
}
],
"practiceLocations": [
{
"address_1": "2651 E Discovery Pkwy",
"address_purpose": "LOCATION",
"city": "Bloomington",
"state": "IN",
"postal_code": "474089059",
"country_code": "US",
"telephone_number": "812-353-9515",
"fax_number": "812-353-9275",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "JUSTIN",
"middle_name": "DAVID",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-05",
"last_updated": "2024-06-14",
"certification_date": "2024-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IN",
"license": "01089817A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PTAN",
"identifier": "1103692253",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300063763",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "264430I01",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jsmith@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1701 N Senate Blvd Rm Ag012",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462021239",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jsmith@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2651 E Discovery Pkwy",
"city": "Bloomington",
"state": "IN",
"country_code": "US",
"postal_code": "474089059",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.