Leroy Carter Smith, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

41584 Issued in AZ

Practice address

2755 Silver Creek Rd
Suite 111
Bullhead City, AZ 86442-7904

Phone

(928) 704-7163

Fax

(928) 704-7140

NPI assigned

May 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

General Surgery

Education

Washington University School of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-State Memorial HospitalGroup PAC ID 4082502422, shared by 3 NPIs, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tri-State Memorial Hospital Hospital, Clarkston, WA, CCN 501332
• St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leroy.smith@tsmh.medicity.net

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.

• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1598814352

  Family Medicine

  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221
  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Community Based Hospice Care Agency
  • Clarkston, WA
  • NPI 1831100254

  Family Medicine

  NPD
• Tri-State Memorial Hospital

  • Family Medicine Physician
  • Clarkston, WA
  • NPI 1932405693
  NPD
• Rmsa Inc Health Center

  • Geriatric Medicine (Family Medicine) Physician
  • Reidsville, NC
  • NPI 1679525380

  Adult Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Hospital LLC

  • Oxygen Equipment & Supplies (DME)
  • Lewiston, ID
  • NPI 1992231799

  Hospital

  Care Compare affiliation
• St. Joseph Hospital LLC

  • General Acute Care Hospital
  • Lewiston, ID
  • NPI 1225090954
  Care Compare affiliation
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221
  Care Compare affiliation
• Tri-State Memorial Hospital

  • Family Medicine Physician
  • Clarkston, WA
  • NPI 1932405693

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1700830601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 SILVER CREEK RD",
            "address_2": "SUITE 111",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427904",
            "telephone_number": "928-704-7163",
            "fax_number": "928-704-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 SILVER CREEK RD",
            "address_2": "SUITE 111",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427904",
            "telephone_number": "928-704-7163",
            "fax_number": "928-704-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LEROY",
        "middle_name": "CARTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NC",
            "license": "26371",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "26371",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "41584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8977958",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "412862",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maren Dela Cruz Simpson
• Scott Simpson
• Dyan Sinclair, FNP-C
• Abhilasha Singh Jones, MD
• Earl A Smith Estate, DDS
• Smiths Food & Drug Centers Inc
• Someone Who Cares in Home Assited Living
• Parminder Kaur Sond, M.D.
• Sonora Quest Laboratories, LLC
• Mitchell Sopko, OT

• Surgery Physician in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.