Active NPI
Elizabeth N. Smith, P.A.
- Physician Assistant
- Gray, LA
National Provider Identifier
1689090433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.200654
- Practice address
- 123 Frontage Road a
Gray, LA 70359-6301 - Phone
- (985) 580-1200
- NPI assigned
- Mar 17, 2014
- Last updated
- Dec 6, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.200654 | LA | Primary |
Addresses
Primary practice location
123 Frontage Road a
Gray, LA 70359-6301
Mailing address
123 Frontage Road a
Gray, LA 70359-6301
Phone (985) 580-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161119000032 | LA | Practitioner - Physician Assistant | 1850670571 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jaime M. Cordova, M.D., Apmc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Breaux Bridge, LA
- NPI 1447554365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480982400000",
"number": "1689090433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 FRONTAGE ROAD A",
"city": "GRAY",
"state": "LA",
"postal_code": "703596301",
"telephone_number": "985-580-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 FRONTAGE ROAD A",
"city": "GRAY",
"state": "LA",
"postal_code": "703596301",
"telephone_number": "985-580-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ELIZABETH",
"middle_name": "N.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-17",
"last_updated": "2016-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "LA",
"license": "PA.200654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gray, LA
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.