Peter Trent Smith MD PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301053454 Issued in MI

Legal business name

PETER TRENT SMITH MD PC

Practice address

3410 E 12 Mile Rd Ste B
Warren, MI 48092-2593

Phone

(586) 383-0920

Fax

(586) 920-2503

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Peter Trent Smith, M.D.NPI 1750458386

Title

President

Phone

(586) 383-0920

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Trent Smith, MD

  • Psychiatry Physician
  • Warren, MI
  • NPI 1750458386
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1548275241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 E 12 MILE RD STE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922593",
            "telephone_number": "586-383-0920",
            "fax_number": "586-920-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 E 12 MILE RD STE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922593",
            "telephone_number": "586-383-0920",
            "fax_number": "586-920-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER TRENT SMITH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2022-08-01",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "TRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-383-0920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301053454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jolonda Janae Peters, LLMSW
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• Psychiatry Physician in Warren, MI
• Providers in Warren, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.