Organization Active NPI

Emily D Smith MD PLLC

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1740355940
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301058103 Issued in MI
Legal business name
EMILY D SMITH MD PLLC
Practice address
20905 Greenfield Rd
Ste. 403
Southfield, MI 48075-5360
Phone
(248) 559-1911
Fax
(248) 559-1912
NPI assigned
Nov 22, 2006
Last updated
Apr 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Dr. Emily D Smith, MDNPI 1235203779
Title
Owner
Phone
(248) 559-1911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301058103 MI Primary

Addresses

Primary practice location

20905 Greenfield Rd
Ste. 403
Southfield, MI 48075-5360

Mailing address

20905 Greenfield Rd
Ste. 403
Southfield, MI 48075-5360
Phone (248) 559-1911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080422000745 MI Part B Supplier - Clinic/Group Practice 2365520921 Receives reassigned benefits from 1 practitioner
Practice locations: Southfield, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0997193Emily D Smith MD PLLC20905 Greenfield Road, Suite 207, Southfield, MI 48075Certificate of waiverMar 7, 2028

National Provider Directory

National Provider Directory

Locations

20905 Greenfield Rd
Ste 403
Southfield, MI 48075
Phone (248) 559-1911

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1740355940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD",
            "address_2": "STE. 403",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755360",
            "telephone_number": "248-559-1911",
            "fax_number": "248-559-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD",
            "address_2": "STE. 403",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755360",
            "telephone_number": "248-559-1911",
            "fax_number": "248-559-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMILY D SMITH MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-559-1911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301058103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.