Bert Jackson Smith, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101256885 Issued in VA

Practice address

2717 E. Oakland Avenue
Johnson City, TN 37601

Phone

(423) 926-2358

Fax

(276) 258-4056

NPI assigned

Oct 24, 2006

Last updated

Jun 4, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in TN, VA, GA, SC4 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 4

Specialty

Internal Medicine

Education

East Tennessee State University Quillen College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Health Transitions, PLLCGroup PAC ID 7315242302, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

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

Owned or controlled facilities with NPI records 2

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

• NHC Healthcare-Athens LLC

  • Skilled Nursing Facility
  • Athens, TN
  • NPI 1316992274

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• NHC Healthcare-Knoxville LLC

  • Skilled Nursing Facility
  • Knoxville, TN
  • NPI 1750306759

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Integrated Health Transitions, PLLC

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1922463470

  SC, VA

  Medicare reassignment Care Compare group NPD Authorized official
• Renuven Aco PLLC

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1568209872

  GA, SC, VA

  Medicare reassignment NPD Authorized official
• Renuven Health Partners of Georgia PC

  • Internal Medicine Physician
  • Fort Oglethorpe, GA
  • NPI 1871196519
  Medicare reassignment NPD Authorized official
• Blue Ridge Medical Management Corporation

  dba First Assist Urgent Care

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment NPD
• RHP Management Services PLLC

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1881525640
  Authorized official Same address or phone
• Blue Ridge Medical Management Corporation

  dba First Assist Urgent Care

  • Urgent Care Clinic/Center
  • Kingsport, TN
  • NPI 1982882379
  NPD
• Cogent Healthcare of Georgia PC

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1609827823
  NPD
• Hospitalist Medicine Physicians of Virginia LLC

  • Internal Medicine Physician
  • Winchester, VA
  • NPI 1770756991
  NPD
• Knoxville Health Care Center, LP

  dba NHC HealthCare, Fort Sanders

  • Skilled Nursing Facility
  • Knoxville, TN
  • NPI 1164467270
  NPD (past)
• NHC Healthcare-Athens LLC

  • Skilled Nursing Facility
  • Athens, TN
  • NPI 1316992274
  NPD (past)
• NHC Healthcare-Knoxville LLC

  • Skilled Nursing Facility
  • Knoxville, TN
  • NPI 1750306759
  NPD (past)
• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Hospitalist Physician
  • Abingdon, VA
  • NPI 1104171826

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1497839070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 EAST OAKLAND AVENUE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011843",
            "telephone_number": "423-926-2358",
            "fax_number": "423-926-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 E. OAKLAND AVENUE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37601",
            "telephone_number": "423-926-2358",
            "fax_number": "276-258-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BERT",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "43425",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101256885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00844330",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q002701",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497839070",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497839070",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506626",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506627",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913158",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100075230",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Lauren Smith Johnson, FNP
• Meagan Elizabeth Smith- Quisenberry, LPC
• Adam E Smith
• Alisa D. Smith, LPT
• Amanda Milan Smith, FNP
• Bianca N Smith, FNP
• Caleb A Smith, DO
• Candice Ashley Smith, B.A.
• Chandar Smith
• Christian Zach Smith, CPO

• Internal Medicine Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.

Verify at the official NPI Registry.