NPIMap

Individual provider Active NPI

Anthony Van Smith, M.D.

  • Family Medicine Physician
  • Augusta, GA
National Provider Identifier
1740267194
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
035525 Issued in GA
Practice address
1417 Pendleton Rd
Augusta, GA 30904-4837
Phone
(706) 738-9824
Fax
(706) 736-4111
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 035525 GA Primary

Addresses

Primary practice location

1417 Pendleton Rd
Augusta, GA 30904-4837

Mailing address

1417 Pendleton Rd
Augusta, GA 30904-4837
Phone (706) 738-9824

Other identifiers 2

IdentifierTypeStateIssuer
153050MedicaidSC
00486461BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20101028000087 GA Practitioner - Family Practice 2961567219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

2258 Wrightsboro Rd
Suite 170
Augusta, GA 30904-4788
Phone (706) 721-8623

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15305SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Au Medical Associates Inc CurrentSince Apr 1, 2018 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2024 Accepting new patients
Au Medical Associates Inc CurrentSince Apr 1, 2018 Accepting new patients

Locations

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

1417 Pendleton Rd
Augusta, GA 30904
Phone (706) 738-9824

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

350 Austin Graybill Rd
North Augusta, SC 29860
Phone (706) 736-5244

Organizations & group practices 5

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 5

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1740267194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 PENDLETON RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044837",
            "telephone_number": "706-738-9824",
            "fax_number": "706-736-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 PENDLETON RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044837",
            "telephone_number": "706-738-9824",
            "fax_number": "706-736-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANTHONY",
        "middle_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "035525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153050",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00486461B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.