Daphene Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

009234 Issued in GA

Practice address

101 Regency Park Dr Ste 110
McDonough, GA 30253-7076

Phone

(404) 996-0126

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.62 of 100Reported as apm

Quality

83.25

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment Care Compare group
• Wellstreet of Georgia PC

  • Urgent Care Clinic/Center
  • Newnan, GA
  • NPI 1235411547
  Medicare reassignment Care Compare group
• Central Georgia Emergency Group, LLC

  • Emergency Medicine Physician
  • Macon, GA
  • NPI 1598126641
  Medicare reassignment NPD
• South Atlanta Urgent Care Clinic LLC

  • Urgent Care Clinic/Center
  • Atlanta, GA
  • NPI 1144548363
  Medicare reassignment
• Swift Health Medical Group

  • Urgent Care Clinic/Center
  • Morrow, GA
  • NPI 1811434210
  Medicare reassignment
• Cep America, LLC

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1619332046
  Medicare reassignment
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Bridgeton, MO
  • NPI 1851946370
  NPD
• Crossroads Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Effingham, IL
  • NPI 1023033982
  NPD (past)
• Southern Illinois Regional Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Washington Park, IL
  • NPI 1265588776
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1497869689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 HIGHWAY 34 E STE 1200",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302656416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 REGENCY PARK DR STE 110",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537076",
            "telephone_number": "404-996-0126"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1835 Kingshighway",
            "address_purpose": "LOCATION",
            "city": "East Saint Louis",
            "state": "IL",
            "postal_code": "622042135",
            "country_code": "US",
            "telephone_number": "618-482-7922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAPHENE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085002952",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "009234",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "085-002952",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2008018559",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002952",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Smiley
• Amy D Smith, NP
• Angela Smith
• Ariel Smith
• Autumn Smith
• Deja Smith
• Deniece Smith, NTP
• John Darrell Smith, MD
• Jose Thomas Smith, M.D.
• Kendolyn Smith, PHARMD, MPH

• Physician Assistant in McDonough, GA
• Providers in McDonough, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.

Verify at the official NPI Registry.