Individual provider Active NPI

Anthony Scott Smith, D.C.

  • Chiropractor
  • Lakewood, CA
National Provider Identifier
1609161454
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
31520 Issued in CA
Practice address
5687 Woodruff Ave
Lakewood, CA 90713-1129
Phone
(562) 866-8384
Fax
(562) 920-1454
NPI assigned
Jun 9, 2011
Last updated
Jun 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 31520 CA Primary
Sports Physician Chiropractor 111NS0005X 31520 CA

Addresses

Primary practice location

5687 Woodruff Ave
Lakewood, CA 90713-1129

Mailing address

5687 Woodruff Ave
Lakewood, CA 90713-1129
Phone (562) 866-8384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181204003657 CA Practitioner - Chiropractic 5496099236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3816 Woodruff Ave
Suite 210
Long Beach, CA 90808-2146
Phone (562) 653-4079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31520CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smith Sports Chiropractic and Wellness, Inc. Sports Physician CurrentSince Jan 1, 2023 Accepting new patients
Weddle Sports Chiropractic and Wellness, Inc Sports Physician CurrentSince Jan 1, 2023 Accepting new patients

Locations

3816 Woodruff Ave
Ste 210
Long Beach, CA 90808
Phone (562) 653-4079

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": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1609161454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5687 WOODRUFF AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131129",
            "telephone_number": "562-866-8384",
            "fax_number": "562-920-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5687 WOODRUFF AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131129",
            "telephone_number": "562-866-8384",
            "fax_number": "562-920-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANTHONY",
        "middle_name": "SCOTT",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "31520",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "31520",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.