NPIMap

Individual provider Active NPI

Julian Kevin Smith, P.A.

  • Physician Assistant
  • Clayton, NC
National Provider Identifier
1720087133
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-02198 Issued in NC
Practice address
2196 NC Highway 42 W
Clayton, NC 27520-8343
Phone
(919) 220-5255
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-02198 NC Primary

Addresses

Primary practice location

2196 NC Highway 42 W
Clayton, NC 27520-8343

Mailing address

PO Box 5105
Belfast, ME 04915-5100
Phone (919) 220-5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101013000509 NC Practitioner - Physician Assistant 1557302718 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

1900 Kildaire Farm Rd
Cary, NC 27518-6616
Phone (919) 350-8000

2325 Stantonsburg Rd
Greenville, NC 27834-7534
Phone (919) 731-4048

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7270

Hospital & facility affiliations

  • Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040
  • Vidant Duplin Hospital Hospital, Kenansville, NC, CCN 340120
  • Vidant Chowan Hospital Hospital, Edenton, NC, CCN 341318
  • Unc Health Care Wayne Hospital, Goldsboro, NC, CCN 340010
  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-02198NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Apr 25, 2024 Accepting new patients
Emergeortho PA Physician Assistant CurrentSince Nov 13, 2023 Accepting new patients
Wakemed Specialists Group, LLC CurrentSince Jun 10, 2024 Accepting new patients
Emergeortho PA CurrentSince Nov 13, 2023 Accepting new patients
Pee Dee Orthopedic Assoc Past Accepting new patients
Pee Dee Orthopedic Assoc PastSince Dec 1, 1993 Accepting new patients

Locations

2325 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 752-5156

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

2920 Highwoods Blvd
Raleigh, NC 27604

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Interoperability endpoints

  • Direct secure messaging: jsmith7437@directhisp.wakemed.org

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 7

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1720087133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "919-220-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2196 NC HIGHWAY 42 W",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275208343",
            "telephone_number": "919-220-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JULIAN",
        "middle_name": "KEVIN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.