Individual provider Active NPI

Paul E Smith III, DO

  • Family Medicine Physician
  • Jackson, KY
National Provider Identifier
1649226895
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
03402 Issued in KY
Practice address
1550 Highway 15 S Ste 200
Jackson, KY 41339-0714
Phone
(606) 666-8404
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 03402 KY
Family Medicine Physician 207Q00000X 03402 KY Primary

Addresses

Primary practice location

1550 Highway 15 S Ste 200
Jackson, KY 41339-0714

Mailing address

6 Fontaine Blvd
Winchester, KY 40391-9216
Phone (231) 742-1213

Other practice location 1

624 Chamberlin Ave
Frankfort, KY 40601-4220
Phone (502) 699-2267

Other identifiers 3

IdentifierTypeStateIssuer
PS012921OtherMIBLUE CROSS
7100177400MedicaidKY
114947926MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110930000372 KY Practitioner - Emergency Medicine 3577468750 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
West Virginia School of Osteopathic Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2108 Nicholasville Rd
Lexington, KY 40503-2502

3900 Kresge Way
Louisville, KY 40207-4681

610 E Brannon Rd
Nicholasville, KY 40356-6046

644 University Shopping Ctr
Richmond, KY 40475-2614
Phone (859) 624-5684

648 University Shopping Ctr
Richmond, KY 40475-2614
Phone (859) 623-0535

96 Future Dr
Corbin, KY 40701-8988
Phone (606) 528-0305

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
03402KYMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince May 1, 2023 Accepting new patients
Kentucky Mso LLC Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince May 1, 2023 Accepting new patients
Kentucky Mso LLC CurrentSince Jun 8, 2015 Accepting new patients
Kentucky Mso, LLC Family Medicine CurrentSince Jun 8, 2015 Accepting new patients
Kalamazoo Emergency Associates, PLC Past Accepting new patients
Lakeshore Emergency Solutions, PLLC Past Accepting new patients
Shelby Emergency Services, LLC Past Accepting new patients

Locations

96 Future Dr
Corbin, KY 40701

1502 Oxford Dr
Ste 100
Georgetown, KY 40324
Phone (502) 570-3785

1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100

2108 Nicholasville Rd
Lexington, KY 40503
Phone (859) 260-5200

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

648 University Shopping Ctr
Richmond, KY 40475
Phone (859) 623-1950

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649226895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 FONTAINE BLVD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403919216",
            "telephone_number": "231-742-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 HIGHWAY 15 S STE 200",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413390714",
            "telephone_number": "606-666-8404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 Chamberlin Ave",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "KY",
            "postal_code": "406014220",
            "country_code": "US",
            "telephone_number": "502-699-2267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "KY",
            "license": "03402",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "03402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PS012921",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100177400",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114947926",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, KY

Sources for this page

Verify at the official NPI Registry.