Mark Alan Smith I, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

096869 Issued in NC

Practice address

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Phone

(336) 718-8278

NPI assigned

Aug 22, 2005

Last updated

Oct 28, 2020By 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msmith129705@direct.novanthealth.org

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.

• Novant Health Rowan Medical Center LLC

  • Neurology Physician
  • Salisbury, NC
  • NPI 1508931544

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Providence Anesthesiology Associates, P.a.

  • Anesthesiology Physician
  • Charlotte, NC
  • NPI 1396739884
  Medicare reassignment NPD
• Novant Health Rowan Medical Center, LLC

  dba NH Rowan Cancer Clinics

  • Hematology & Oncology Physician
  • Salisbury, NC
  • NPI 1427770130
  NPD
• Rowan Regional Medical Center

  dba Novant Health Heart and Vascular Institute

  • Cardiovascular Disease Physician
  • Salisbury, NC
  • NPI 1679812010
  NPD
• Spartanburg Hospital for Restorative Care

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1649293580
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1639161029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 LAUREL VIEW DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271045101",
            "telephone_number": "336-774-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "APN 323",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "096869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MSMITH129705@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "3333 Silas Creek Pkwy",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lacechave Smith
• Lavorice Smith
• Leigh Anne Smith, CNM
• Lonnie W. Smith Jr., PHD, LPC, NCC
• Madeline Clare Smith, MD
• Melissa R Smith, PA-C
• Meredith S. Smith, PA
• Michael Smith
• Nancy Smith, PT, DPT
• Natalie Francis Smith, DO

• Certified Registered Nurse Anesthetist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.