NPIMap

Individual provider Active NPI

Brandon Alan Smith, M.D.

  • Internal Medicine Physician
  • Dalton, GA
National Provider Identifier
1497998223
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
67165 Issued in GA
Practice address
1114 Professional Blvd
Dalton, GA 30720-2588
Phone
(706) 278-0138
NPI assigned
Apr 9, 2009
Last updated
Oct 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 67165 GA Primary

Addresses

Primary practice location

1114 Professional Blvd
Dalton, GA 30720-2588

Mailing address

1114 Professional Blvd
Dalton, GA 30720-2588
Phone (706) 278-0138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120806000064 GA Practitioner - Internal MedicinePractitioner - Family Practice 9638325715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dalton Family Practice, P.C.Group PAC ID 6103817572, 8 clinicians

Practice addresses (Care Compare)

1114 Professional Blvd
Dalton, GA 30720-2588
Phone (706) 278-0138

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67165GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Physician Group Inc CurrentSince Aug 13, 2012 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Aug 13, 2012 Accepting new patients
Dalton Family Practice, P.C. CurrentSince Mar 1, 2013 Accepting new patients
Ecc Hospitalist Services PC Internal Medicine Past Accepting new patients

Locations

1114 Professional Blvd
Dalton, GA 30720
Phone (706) 278-0138

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

Interoperability endpoints

  • Direct secure messaging: admin@daltonfamily.e-mdsdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1497998223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202588",
            "telephone_number": "706-278-0138",
            "fax_number": "706-278-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202588",
            "telephone_number": "706-278-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRANDON",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "67165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.