Individual provider Active NPI

Allen David Smith, PA-C

  • Medical Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1609911619
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 9103846 Issued in FL
Practice address
1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone
(850) 878-8714
Fax
(850) 878-2464
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 9103846 FL Primary

Addresses

Primary practice location

1300 Miccosukee Rd
Tallahassee, FL 32308-5054

Mailing address

1607 Saint James CT
Tallahassee, FL 32308-5352
Phone (850) 878-8714

Other practice location 1

1841 Fiddler Ct
Tallahassee, FL 32308-4450
Phone (850) 942-0039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110621000686 FL Practitioner - Physician Assistant 9234317215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 431-1155

1401 Centerville Rd
Tallahassee, FL 32308-4639

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9103846FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc CurrentSince Jan 28, 2018 Accepting new patients

Locations

15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

1309 Thomasville Rd
Tallahassee, FL 32303
Phone (850) 431-5910

1607 Saint James Ct
Ste 2
Tallahassee, FL 32308
Phone (850) 878-8714

1401 Centerville Rd
Ste G02
Tallahassee, FL 32308
Phone (850) 431-2100

Interoperability endpoints

  • Direct secure messaging: asmith21419@tallahasseememorial.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1609911619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 SAINT JAMES CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085352",
            "telephone_number": "850-878-8714",
            "fax_number": "850-878-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-878-8714",
            "fax_number": "850-878-2464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1841 Fiddler Ct",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323084450",
            "country_code": "US",
            "telephone_number": "850-942-0039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALLEN",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9103846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.