Active NPI
William Keith Smith Jr., DPM
- Foot & Ankle Surgery Podiatrist
- Shawnee, OK
National Provider Identifier
1699757336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 205
- Practice address
- 1627 N Kickapoo Ave
Shawnee, OK 74804-4313 - Phone
- (405) 275-8234
- Fax
- (405) 275-7298
- NPI assigned
- Nov 17, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 205 | OK | Primary |
Addresses
Primary practice location
1627 N Kickapoo Ave
Shawnee, OK 74804-4313
Mailing address
1627 N Kickapoo Ave
Shawnee, OK 74804-4313
Phone (405) 275-8234
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01598903 | Other | OK | RAILROAD MEDICARE |
| 100779890C | Medicaid | OK |
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 |
|---|---|---|---|
| 205 | OK | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lance E Hardison DPM PC | Foot & Ankle Surgery | Past | Accepting new patients |
| Aggeus Healthcare, P.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Foot & Ankle Surgery Podiatrist
- Oklahoma City, OK
- NPI 1639248149
-
- Podiatrist
- Chicago, IL
- NPI 1033156955
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1699757336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1627 N KICKAPOO AVE",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748044313",
"telephone_number": "405-275-8234",
"fax_number": "405-275-7298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1627 N KICKAPOO AVE",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748044313",
"telephone_number": "405-275-8234",
"fax_number": "405-275-7298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "WILLIAM",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-17",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "OK",
"license": "205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01598903",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100779890C",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shawnee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.