Individual provider Active NPI

Lynn Cameron Smitherman, MD

  • Pediatrics Physician
  • Detroit, MI
National Provider Identifier
1609814722
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301407205 Issued in MI
Practice address
3950 Beaubien - 1St FL
Childrens Hospital of Mi
Detroit, MI 48201-2119
Phone
(313) 832-8290
Fax
(313) 993-0081
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301407205 MI Primary

Addresses

Primary practice location

3950 Beaubien - 1St FL
Childrens Hospital of Mi
Detroit, MI 48201-2119

Mailing address

4201 St. Antoine - Uhc 5D Mailbox 226
University Pediatricians
Detroit, MI 48201-2153
Phone (313) 745-4405

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070517000313 MI Practitioner - Pediatric Medicine 9931206414 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301407205MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians Pediatrics CurrentSince Dec 17, 2012 Accepting new patients
Wayne Pediatrics Inc. Pediatrics CurrentSince Feb 23, 2021 Accepting new patients
University Pediatricians Pediatrics CurrentSince Dec 17, 2012 Accepting new patients
Resilience Healthcare - Lakefront Medical Associates, LLC PastSince Feb 23, 2021 Accepting new patients
University Physician Group Past Accepting new patients

Locations

4201 Saint Antoine St
Ste 226
Detroit, MI 48201
Phone (313) 966-2064

400 Mack Ave
Ste 1
Detroit, MI 48201
Phone (313) 448-9600

3950 Beaubien St
Fl 4
Detroit, MI 48201
Phone (313) 832-9220

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

4201 Saint Antoine St
#4B
Detroit, MI 48201
Phone (313) 745-4879

3950 Beaubien St
Detroit, MI 48201
Phone (313) 745-5437

400 Mack Ave
Ste 9
Detroit, MI 48201

Interoperability endpoints

  • Direct secure messaging: lsmitherman681953@direct.hfhs.org
  • Direct secure messaging: lsmither@direct.dmc.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1609814722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 ST. ANTOINE - UHC 5D MAILBOX 226",
            "address_2": "UNIVERSITY PEDIATRICIANS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4405",
            "fax_number": "313-966-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 BEAUBIEN - 1ST FL",
            "address_2": "CHILDRENS HOSPITAL OF MI",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-832-8290",
            "fax_number": "313-993-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHERMAN",
        "first_name": "LYNN",
        "middle_name": "CAMERON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301407205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.