Individual provider Active NPI

Mitchell W. Smith, D.O.

  • Allergy & Immunology Physician
  • Greenwood, IN
National Provider Identifier
1700101102
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
02004276A Issued in IN
Practice address
965 Emerson Pkwy
Suite B
Greenwood, IN 46143-6273
Phone
(317) 865-0055
Fax
(317) 865-0056
NPI assigned
Mar 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 02004276A IN Primary

Addresses

Primary practice location

965 Emerson Pkwy
Suite B
Greenwood, IN 46143-6273

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 3

IdentifierTypeStateIssuer
IN1127019OtherINMEDICARE PTAN
IN1125020OtherINMEDICARE PTAN
201095070MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20140321001786 IN Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 5890926505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Partners PLLCGroup PAC ID 7113822420, 144 clinicians

Practice addresses (Care Compare)

965 Emerson Pkwy
Suite B
Greenwood, IN 46143-6274
Phone (317) 865-0055

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02004276AINMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Indiana Allergy LLC Allergy Current Accepting new patients
Franciscan Physician Network Internal Medicine Current Accepting new patients
Franciscan Physician Network CurrentSince Feb 10, 2014 Accepting new patients
Allergy Partners, PLLC Allergy & Immunology CurrentSince Dec 7, 2020 Accepting new patients
Allergy Partners, PLLC Allergy & Immunology Current Accepting new patients
Franciscan Physician Network CurrentSince Feb 10, 2014 Accepting new patients
NPI 1508468638 Allergy & Immunology CurrentSince Dec 7, 2020 Accepting new patients
Major Hospital Past Accepting new patients

Locations

6781 E US Highway 36
Ste 300
Avon, IN 46123
Phone (317) 272-8095

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

11501 Cumberland Rd
Ste 500
Fishers, IN 46037
Phone (317) 621-9393

965 Emerson Pkwy
Ste B
Greenwood, IN 46143
Phone (317) 865-0055

5255 E Stop 11 Rd
Ste 260
Indianapolis, IN 46237
Phone (317) 865-0055

9002 N Meridian St
Ste 107
Indianapolis, IN 46260
Phone (317) 848-4070

902 N Samuel Moore Pkwy
Mooresville, IN 46158
Phone (317) 831-3400

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 7

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 6

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": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1700101102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 EMERSON PKWY",
            "address_2": "SUITE B",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436273",
            "telephone_number": "317-865-0055",
            "fax_number": "317-865-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MITCHELL",
        "middle_name": "W.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IN",
            "license": "02004276A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IN1127019",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IN1125020",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201095070",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.