Individual provider Active NPI

Trueman David Smith, M.D.

  • General Practice Physician
  • Cookeville, TN
National Provider Identifier
1497715767
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
25583 Issued in TN
Practice address
315 N Washington Ave
Suite 265
Cookeville, TN 38501-2603
Phone
(931) 854-9432
Fax
(931) 854-9434
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 25583 TN Primary

Addresses

Primary practice location

315 N Washington Ave
Suite 265
Cookeville, TN 38501-2603

Mailing address

315 N Washington Ave
Suite 265
Cookeville, TN 38501-2603
Phone (931) 854-9432

Other identifiers 1

IdentifierTypeStateIssuer
3084649MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20100921000218 TN Practitioner - General Practice 2860517380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Dalhousie University Faculty of Dentistry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Father and Son Family Medicine Clinic, PLLCGroup PAC ID 4880906171, 2 clinicians

Practice addresses (Care Compare)

315 N Washington Ave
Suite 210
Cookeville, TN 38501-2660
Phone (931) 854-9432

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25583TNMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Father and Son Family Medicine Clinic, PLLC CurrentSince Jul 1, 2015 Accepting new patients
Amg-Livingston LLC Past Accepting new patients

Locations

315 N Washington Ave
Ste 210
Cookeville, TN 38501
Phone (931) 526-7171

315 N Washington Ave
Ste 265
Cookeville, TN 38501
Phone (931) 520-1696

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 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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1497715767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N WASHINGTON AVE",
            "address_2": "SUITE 265",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012603",
            "telephone_number": "931-854-9432",
            "fax_number": "931-854-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N WASHINGTON AVE",
            "address_2": "SUITE 265",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012603",
            "telephone_number": "931-854-9432",
            "fax_number": "931-854-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TRUEMAN",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "25583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3084649",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.