Individual provider Active NPI

Erin Michelle Smith, PSY.D.

  • Clinical Psychologist
  • Madison, AL
National Provider Identifier
1558385690
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1197 Issued in AL
Practice address
100 Essex CT
Suite B
Madison, AL 35758-3139
Phone
(256) 774-7100
Fax
(256) 774-7579
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1197 AL Primary

Addresses

Primary practice location

100 Essex CT
Suite B
Madison, AL 35758-3139

Mailing address

100 Essex CT
Suite B
Madison, AL 35758-3139
Phone (256) 774-7100

Other identifiers 4

IdentifierTypeStateIssuer
51512011OtherALBCBS FEDERAL EMPLOYEES
51507014OtherALBCBS PROVIDER NUMBER
2082972OtherALFIRST HEALTH PROVIDER NUM
281495OtherALUNITED HEALTH CARE

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050518001273 AL Practitioner - Clinical Psychologist 5799726873 Practice locations: Madison, AL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7600 Hwy 72 W
Suite 102
Madison, AL 35758-9510
Phone (256) 774-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1558385690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ESSEX CT",
            "address_2": "SUITE B",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357583139",
            "telephone_number": "256-774-7100",
            "fax_number": "256-774-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ESSEX CT",
            "address_2": "SUITE B",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357583139",
            "telephone_number": "256-774-7100",
            "fax_number": "256-774-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ERIN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FEDERAL EMPLOYEES",
            "identifier": "51512011",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "51507014",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PROVIDER NUM",
            "identifier": "2082972",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "281495",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.