Individual provider Active NPI

Eddy Arnold Smith, PA-C

  • Medical Physician Assistant
  • Gadsden, AL
National Provider Identifier
1497887939
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
01863 Issued in TX
Practice address
2108 Rainbow Dr
Gadsden, AL 35901-5510
Phone
(256) 547-0160
NPI assigned
Mar 11, 2007
Last updated
Jan 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 01863 TX Primary

Addresses

Primary practice location

2108 Rainbow Dr
Gadsden, AL 35901-5510

Mailing address

2108 Rainbow Dr
Suite 100
Gadsden, AL 35901-5510
Phone (256) 547-0160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170410001097 AL Practitioner - Physician Assistant 8022297902 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Med Care of Gadsden, P.C.Group PAC ID 7517870389, 9 clinicians

Practice addresses (Care Compare)

3206 W Meighan Blvd
Gadsden, AL 35904-1726
Phone (256) 547-2153

3206 W Meighan Blvd
Gadsden, AL 35904-1732
Phone (256) 547-2153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
01863TXMDMedical Physician Assistant

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1497887939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 RAINBOW DR",
            "address_2": "SUITE 100",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015510",
            "telephone_number": "256-547-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 RAINBOW DR",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015510",
            "telephone_number": "256-547-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDDY",
        "middle_name": "ARNOLD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-11",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "01863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

Verify at the official NPI Registry.