NPIMap

Individual provider Active NPI

John R Smithson Jr., MD

  • Neurological Surgery Physician
  • Grove, OK
National Provider Identifier
1669465811
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
11399 Issued in OK
Practice address
1120 Neo Loop
Grove, OK 74344-6046
Phone
(918) 786-9568
Fax
(918) 293-3116
NPI assigned
Aug 23, 2005
Last updated
Nov 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 11399 OK Primary

Addresses

Primary practice location

1120 Neo Loop
Grove, OK 74344-6046

Mailing address

1120 Neo Loop
Grove, OK 74344-6046
Phone (918) 786-9568

Other identifiers 1

IdentifierTypeStateIssuer
100088280AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050822001045 OK Practitioner - Neurosurgery 2961311741 Reassigns benefits to 1 organization
I20201202002531 TX Practitioner - Neurosurgery 2961311741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Oklahoma College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Neuro SolutionsGroup PAC ID 9436382967, 7 clinicians

Practice addresses (Care Compare)

2910 Fannin St
Suite B
Beaumont, TX 77701-3901
Phone (409) 833-0093

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11399OKMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Jul 16, 2007 Accepting new patients
US Eeg, LLC CurrentSince Mar 1, 2025 Accepting new patients
St. John Physicians, Inc. Neurological Surgery CurrentSince Jul 16, 2007 Accepting new patients
Advanced Neuro Solutions CurrentSince Mar 1, 2025 Accepting new patients
William L High MD PA PastSince Mar 1, 2025 Accepting new patients
Gemini Medical Group Inc Past Accepting new patients
Neurolinks, LLC Past Accepting new patients
Gemini After Hours Clinic Inc PastSince Dec 1, 2006 Accepting new patients
St. John Physicians, Inc PastSince Apr 28, 2003 Accepting new patients

Locations

226 SE Debell Ave
Ste 101
Bartlesville, OK 74006
Phone (918) 331-9632

1120 Neo Loop
Grove, OK 74344
Phone (918) 786-1991

701 Leahy Ave
Pawhuska, OK 74056
Phone (918) 287-1310

1725 E 19th St
Ste 500
Tulsa, OK 74104
Phone (918) 403-7089

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1145 S Utica Ave
Ste 901
Tulsa, OK 74104
Phone (918) 392-7071

2910 Fannin St
#B
Beaumont, TX 77701
Phone (409) 833-0093

Interoperability endpoints

  • Direct secure messaging: jsmithson839211@ahs.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 7

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1669465811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 NEO LOOP",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743446046",
            "telephone_number": "918-786-9568",
            "fax_number": "918-293-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 NEO LOOP",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743446046",
            "telephone_number": "918-786-9568",
            "fax_number": "918-293-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHSON",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OK",
            "license": "11399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100088280A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove, OK

Sources for this page

Verify at the official NPI Registry.