Individual provider Active NPI

Loretta Lea Smith, PA-C

  • Physician Assistant
  • San Angelo, TX
National Provider Identifier
1639141971
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03323 Issued in TX
Practice address
2237 S Jackson St
San Angelo, TX 76904-5131
Phone
(325) 747-2292
NPI assigned
Feb 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03323 TX Primary

Addresses

Primary practice location

2237 S Jackson St
San Angelo, TX 76904-5131

Mailing address

2237 S Jackson St
San Angelo, TX 76904-5131
Phone (325) 747-2292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040803001079 TX Practitioner - Physician Assistant 6002887148 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511

120 E Harris Ave
San Angelo, TX 76903-5904
Phone (325) 747-6741

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Mar 1, 2008 Accepting new patients
Shannon Clinic CurrentSince May 1, 2023 Accepting new patients
Regional Employee Assistance Program Inc Physician Assistant CurrentSince Mar 1, 2008 Accepting new patients
Ucp Physicians of Central Texas, PLLC CurrentSince Sep 8, 2017 Accepting new patients
San Angelo Emergency Physicians Past Accepting new patients
Regional Employee Assistance Program Inc Past Accepting new patients

Locations

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

2804 Lake Rd
Ste 5
Huntsville, TX 77340
Phone (979) 696-2422

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

3501 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 947-6361

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

3535 Knickerbocker Rd
San Angelo, TX 76904
Phone (915) 947-6495

2237 S Jackson St
San Angelo, TX 76904
Phone (325) 481-2257

120 E Harris Ave
San Angelo, TX 76903
Phone (325) 653-6741

Organizations & group practices 8

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1639141971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2237 S JACKSON ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045131",
            "telephone_number": "325-747-2292",
            "fax_number": "325-747-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2237 S JACKSON ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045131",
            "telephone_number": "325-747-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LORETTA",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.