Daniel Burtion Smith, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036070695 Issued in IL

Practice address

4965 E Lost Bridge Rd
Decatur, IL 62521-5139

Phone

(217) 864-5531

Fax

(217) 864-2449

NPI assigned

Jun 9, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dsmith32572@ewd.direct.hshs.org

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.

• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1699779538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE HIGHWAY 121",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "625491224",
            "telephone_number": "217-864-5531",
            "fax_number": "217-864-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4965 E LOST BRIDGE RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625215139",
            "telephone_number": "217-864-5531",
            "fax_number": "217-864-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIEL",
        "middle_name": "BURTION",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036070695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360706951",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsmith32572@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4965 E Lost Bridge Rd",
            "city": "Decatur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625215139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Addie L Smith, LSW
• Amy Smith, M.S.
• Amy Ann Smith, PA-C
• Andrea Lynne Smith, LSW
• Annie Michele Smith, L.C.S.W.
• Elizabeth K Smith, LPN
• Eric Smith, HIS
• Faith R Smith
• Jeffery M Smith, M.D.
• Joseph Alexander Smith, ATC

• Family Medicine Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.

Verify at the official NPI Registry.