Individual provider Active NPI

Ray C Smith III, M.D.

  • Emergency Medicine Physician
  • Terre Haute, IN
National Provider Identifier
1720005325
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01033441A Issued in IN
Practice address
1606 N 7TH St
Terre Haute, IN 47804-2706
Phone
(812) 442-2500
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01033441A IN Primary
Emergency Medicine Physician 207P00000X 4301042616 MI

Addresses

Primary practice location

1606 N 7TH St
Terre Haute, IN 47804-2706

Mailing address

250 N Shadeland Ave
Suite 130 - Provider Enrollment
Indianapolis, IN 46219-4959
Phone (317) 547-5345

Other identifiers 2

IdentifierTypeStateIssuer
100388340MedicaidIN
930040138OtherINRAILROAD MEDICARE

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

State licenses

LicenseStateTypeSpecialty
01033441AINMDEmergency Medicine Physician
4301042616MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Connorsville Emergency Group PC Emergency Medicine Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
River Crossing Emergency Physicians Emergency Medicine Past Accepting new patients
Midwest Medical Management, P.C. Emergency Medicine Past Accepting new patients
Reddy Pop Emergency Physicians Emergency Medicine Past Accepting new patients
County Seat Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1720005325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "SUITE 130 - PROVIDER ENROLLMENT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959",
            "telephone_number": "317-547-5345",
            "fax_number": "317-962-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 N 7TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042706",
            "telephone_number": "812-442-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RAY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01033441A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301042616",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100388340",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930040138",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.

Verify at the official NPI Registry.