NPIMap

Individual provider Active NPI

Benjamin Probie Smith, M.D.

  • Internal Medicine Physician
  • Keesler Afb, MS
National Provider Identifier
1669783668
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21815 Issued in MS
Practice address
301 Fisher St
Attn Internal Medicine Clinic
Keesler Afb, MS 39534-2508
Phone
(228) 376-0577
Fax
(228) 376-0103
NPI assigned
Jun 24, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 21815 MS
Internal Medicine Physician 207R00000X 21815 MS Primary

Addresses

Primary practice location

301 Fisher St
Attn Internal Medicine Clinic
Keesler Afb, MS 39534-2508

Mailing address

301 Fisher St
Attn Internal Medicine Clinic
Keesler Afb, MS 39534-2508
Phone (228) 376-0577

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150515000414 MS Practitioner - Internal Medicine 0749504678 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exceed Physical Therapy, LLCGroup PAC ID 8123378338, 72 clinicians
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

12261 Hwy 49
Suite 1
Gulfport, MS 39503-2976
Phone (228) 265-7185

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-5201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21815MSMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Jun 6, 2017 Accepting new patients
Caredoc LLC CurrentSince Apr 1, 2025 Accepting new patients
Care Doc LLC Internal Medicine CurrentSince Apr 1, 2025 Accepting new patients
Memorial Hospital at Gulfport Internal Medicine CurrentSince Jun 6, 2017 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients
Encompass Health Rehabilitation Hospital of Gulfport, LLC Past Accepting new patients

Locations

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

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 and National Provider Directory roles.

Hospital & facility affiliations 64

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1669783668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "address_2": "ATTN INTERNAL MEDICINE CLINIC",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-0577",
            "fax_number": "228-376-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "address_2": "ATTN INTERNAL MEDICINE CLINIC",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-0577",
            "fax_number": "228-376-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "middle_name": "PROBIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "21815",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "21815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keesler Afb, MS

Sources for this page

Verify at the official NPI Registry.