William Keith Smith Sr., DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

152 Issued in OK

Practice address

1627 N Kickapoo Ave
Shawnee, OK 74804-4313

Phone

(405) 275-8234

Fax

(405) 275-7298

NPI assigned

Nov 17, 2005

Last updated

Mar 9, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• White Eagle Health Center

  • Clinic/Center
  • Ponca City, OK
  • NPI 1699875724
  Medicare reassignment NPD
• Prairie Gardens Medical LLC

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1689280067
  Medicare reassignment
• White Eagle Health Center

  dba Hope and Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Ponca City, OK
  • NPI 1265271910
  NPD
• Lance E Hardison DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Oklahoma City, OK
  • NPI 1639248149
  NPD (past)
• Aggeus Healthcare, P.C.

  • Podiatrist
  • Chicago, IL
  • NPI 1033156955
  NPD (past)

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1629050364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 N KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748044313",
            "telephone_number": "405-275-8234",
            "fax_number": "405-275-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 N KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748044313",
            "telephone_number": "405-275-8234",
            "fax_number": "405-275-7298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILLIAM",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01598909",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100779540A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry Smith
• Sherry Ann Smith
• Sylvia 'Sherry' Charisse Smith, MHR
• Taylor Smith
• Tiffany Marie Smith, MS,LPC CANDIDATE
• William Keith Smith Jr., DPM
• Raechell Lynnann Snake, LPN
• Lori Ann Snyder, LPN
• John Soap Jr.
• Solara Hospital Shawnee, LLC (Cornerstone Specialty Hospitals Shawnee)

• Foot & Ankle Surgery Podiatrist in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Foot & Ankle Surgery Podiatrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.