Active NPI
Stephen Lowell Smith, M.D.
- Surgery Physician
- Newport Coast, CA
National Provider Identifier
1639168156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- G52278
- Practice address
- 39 Lessay
Newport Coast, CA 92657-1025 - Phone
- (904) 315-5505
- NPI assigned
- Oct 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME61688 | FL | |
| Surgery Physician | 208600000X | G52278 | CA | Primary |
Addresses
Primary practice location
39 Lessay
Newport Coast, CA 92657-1025
Mailing address
39 Lessay
Newport Coast, CA 92657-1025
Phone (904) 315-5505
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 266978 | Other | FL | AVMED |
| 823712756A | Medicaid | GA | |
| P00676831 | Other | FL | RAILROAD MEDICARE |
| 3646090 | Other | CIGNA | |
| 4043095 | Other | FL | AETNA |
| 14611 | Other | FL | BLUECROSS/BLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G52278 | CA | MD | Surgery Physician |
| 52278 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654819200000",
"number": "1639168156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 LESSAY",
"city": "NEWPORT COAST",
"state": "CA",
"postal_code": "926571025",
"telephone_number": "904-315-5505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 LESSAY",
"city": "NEWPORT COAST",
"state": "CA",
"postal_code": "926571025",
"telephone_number": "904-315-5505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "STEPHEN",
"middle_name": "LOWELL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-18",
"last_updated": "2022-06-10",
"certification_date": "2022-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME61688",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G52278",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "266978",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "823712756A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00676831",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3646090",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4043095",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS/BLUESHIELD",
"identifier": "14611",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newport Coast, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.