Individual provider Active NPI

William Anthony Smithson, M.D.

  • Pediatrics Physician
  • Rochester, MN
National Provider Identifier
1528115573
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
21348 Issued in MN
Practice address
2600 18TH Ave SW
Rochester, MN 55902-1172
Phone
(507) 269-1303
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 1439 SD
Pediatrics Physician 208000000X 21348 MN Primary

Addresses

Primary practice location

2600 18TH Ave SW
Rochester, MN 55902-1172

Mailing address

2600 18TH Ave SW
Rochester, MN 55902-1172
Phone (507) 269-1303

Other identifiers 2

IdentifierTypeStateIssuer
758513600MedicaidMN
0569889MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21348MNMDPediatrics Physician
1439SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Hematology Clinic LTD Pediatric Hematology-Oncology Past Accepting new patients
Pediatric Hematology Oncology Pharmacy LTC Past Accepting new patients

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, 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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1528115573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 18TH AVE SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559021172",
            "telephone_number": "507-269-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 18TH AVE SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559021172",
            "telephone_number": "507-269-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHSON",
        "first_name": "WILLIAM",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "SD",
            "license": "1439",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "21348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "758513600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0569889",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.