Active NPI
Wayne Graham Smith, D.C.
- Chiropractor
- Saint Albans, VT
National Provider Identifier
1750343992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 006.0064013
- Practice address
- 158 Lake St
Saint Albans, VT 05478-2278 - Phone
- (864) 494-3555
- Fax
- (802) 782-8862
- NPI assigned
- Apr 4, 2006
- Last updated
- Jul 13, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 006.0064013 | VT | Primary |
| Nutrition Chiropractor | 111NN1001X | 06.0064013 | VT | |
| Rehabilitation Chiropractor | 111NR0400X | 06.0064013 | VT |
Addresses
Primary practice location
158 Lake St
Saint Albans, VT 05478-2278
Mailing address
5129 Ethan Allen Hwy
Saint Albans, VT 05478-6071
Phone (864) 494-3555
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001617502 | Other | VT | MEDICARE PTAN |
| GCH365 | Medicaid | SC | |
| CH2393 | Medicaid | SC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2393 | SC | MD | Professional Counselor |
| 006.0064013 | VT | MD | Chiropractor |
| 06.0064013 | VT | MD | Nutrition Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skylyn Wellness Center, Inc. | Chiropractor | Past | Accepting new patients |
| Back to Health Family Chiropractic, P.C. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Saint Albans, VT
- NPI 1326360272
-
- Interventional Pain Medicine Physician
- Spartanburg, SC
- NPI 1124124185
Chiropractor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342137600000",
"number": "1750343992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5129 ETHAN ALLEN HWY",
"city": "SAINT ALBANS",
"state": "VT",
"postal_code": "054786071",
"telephone_number": "864-494-3555",
"fax_number": "802-782-8862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "158 LAKE ST",
"city": "SAINT ALBANS",
"state": "VT",
"postal_code": "054782278",
"telephone_number": "864-494-3555",
"fax_number": "802-782-8862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "WAYNE",
"middle_name": "GRAHAM",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-04",
"last_updated": "2012-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "VT",
"license": "006.0064013",
"primary": true
},
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "VT",
"license": "06.0064013",
"primary": false
},
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "VT",
"license": "06.0064013",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "001617502",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GCH365",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CH2393",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Albans, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.