Organization Active NPI

Mary M Smyth MD PC

  • Otolaryngology Physician
  • Fall River, MA
National Provider Identifier
1710173109
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
082086 Issued in MA
Legal business name
MARY M SMYTH MD PC
Practice address
1030 President Ave
Suite 302
Fall River, MA 02720
Phone
(508) 674-3500
Fax
(508) 674-3535
NPI assigned
Sep 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Authorized official

Name
Mary M Smyth, MD
Title
Physician
Phone
(508) 674-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 082086 MA Primary

Addresses

Primary practice location

1030 President Ave
Suite 302
Fall River, MA 02720

Mailing address

PO Box 9503
Fall River, MA 02720
Phone (508) 674-3500

Other identifiers 1

IdentifierTypeStateIssuer
3148335MedicaidMA

National Provider Directory

National Provider Directory

Locations

1030 President Ave
Ste 302
Fall River, MA 02720
Phone (508) 674-3500

1030 President Ave
#302
Fall River, MA 02720
Phone (508) 674-3500

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1710173109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9503",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02720",
            "telephone_number": "508-674-3500",
            "fax_number": "508-674-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 PRESIDENT AVE",
            "address_2": "SUITE 302",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02720",
            "telephone_number": "508-674-3500",
            "fax_number": "508-674-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY M SMYTH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "SMYTH",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "508-674-3500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "082086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3148335",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.