Active NPI
Richard Dean Smith, M.D.
- Internal Medicine Physician
- Paducah, KY
National Provider Identifier
1710056676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 19479
- Practice address
- 225 Medical Center Drive
Suite 201
Paducah, KY 42003 - Phone
- (270) 441-4200
- Fax
- (270) 441-4249
- NPI assigned
- Nov 7, 2006
- Last updated
- May 5, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 19479 | KY | Primary |
Addresses
Primary practice location
225 Medical Center Drive
Suite 201
Paducah, KY 42003
Mailing address
2200 Jefferson Ave
5TH Floor Mercy Pho/Cvo
Toledo, OH 43604-7101
Phone (419) 251-9830
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64194798 | Medicaid | KY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493942400000",
"number": "1710056676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 JEFFERSON AVE",
"address_2": "5TH FLOOR MERCY PHO/CVO",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436047101",
"telephone_number": "419-251-9830",
"fax_number": "419-251-1826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 MEDICAL CENTER DRIVE",
"address_2": "SUITE 201",
"city": "PADUCAH",
"state": "KY",
"postal_code": "42003",
"telephone_number": "270-441-4200",
"fax_number": "270-441-4249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "RICHARD",
"middle_name": "DEAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2017-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KY",
"license": "19479",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64194798",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.