Individual provider Active NPI

Christopher Shawn Smith, D.O.

  • Emergency Medicine Physician
  • Elizabethton, TN
National Provider Identifier
1699809038
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2164 Issued in TN
Practice address
1501 W Elk Ave
Elizabethton, TN 37643-2874
Phone
(423) 542-1343
NPI assigned
Mar 16, 2007
Last updated
Apr 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2164 TN Primary

Addresses

Primary practice location

1501 W Elk Ave
Elizabethton, TN 37643-2874

Mailing address

1501 W Elk Ave
Elizabethton, TN 37643-2874
Phone (423) 542-1343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20110916000387 TN Practitioner - Emergency Medicine 6709982432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Cities Regional Emergency Physicians, PCGroup PAC ID 3678859477, 118 clinicians

Practice addresses (Care Compare)

1501 W Elk Ave
Elizabethton, TN 37643-2874
Phone (423) 542-1300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
83.8
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2093WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince Apr 1, 2017 Accepting new patients
Norton Community Physician Services LLC Past Accepting new patients
Norton Community Physician Services LLC Past Accepting new patients
Ky-I Medical Services, P.S.C. Past Accepting new patients

Locations

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

Organizations & group practices 4

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 1

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1699809038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W ELK AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432874",
            "telephone_number": "423-542-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W ELK AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432874",
            "telephone_number": "423-542-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTOPHER",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "2164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethton, TN

Sources for this page

Verify at the official NPI Registry.