Individual provider Active NPI

Craig M Smith, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Aransas Pass, TX
National Provider Identifier
1750337960
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00096 Issued in TX
Practice address
1731 W Wheeler Ave
Aransas Pass, TX 78336-4536
Phone
(361) 758-2799
Fax
(361) 758-2707
NPI assigned
May 26, 2006
Last updated
Jan 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00096 TX Primary

Addresses

Primary practice location

1731 W Wheeler Ave
Aransas Pass, TX 78336-4536

Mailing address

1731 W Wheeler Ave
Aransas Pass, TX 78336-4536
Phone (361) 758-2799

Other identifiers 1

IdentifierTypeStateIssuer
133365008MedicaidTX

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
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1750337960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 W WHEELER AVE",
            "city": "ARANSAS PASS",
            "state": "TX",
            "postal_code": "783364536",
            "telephone_number": "361-758-2799",
            "fax_number": "361-758-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 W WHEELER AVE",
            "city": "ARANSAS PASS",
            "state": "TX",
            "postal_code": "783364536",
            "telephone_number": "361-758-2799",
            "fax_number": "361-758-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CRAIG",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA00096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133365008",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aransas Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.