Mark William Smith, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301076489 Issued in MI

Practice address

14734 Park Ave
Charlevoix, MI 49720-1927

Phone

(231) 547-6554

Fax

(231) 547-1179

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marksmith@cah.cernerdirect.com
• Direct secure messaging: msmith148711@mymichiganhealth.midirect.net

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.

• Mackinac Straits Health System Inc

  • Critical Access Hospital
  • Saint Ignace, MI
  • NPI 1124283502

  Family Medicine

  Medicare reassignment NPD
• Mackinac Straits Health System Inc

  • General Practice Physician
  • Saint Ignace, MI
  • NPI 1659536035
  Medicare reassignment NPD
• Northwestern Michigan Emergency Physicians PC

  • Emergency Medicine Physician
  • Traverse City, MI
  • NPI 1073597944
  Medicare reassignment NPD
• Mark W Smith MD PLC LLC

  • Family Medicine Physician
  • Charlevoix, MI
  • NPI 1144489444
  NPD (past) Authorized official
• Mackinac Straits Health System Inc

  • Rural Health Clinic/Center
  • Cheboygan, MI
  • NPI 1659868206

  Family Medicine

  NPD
• Mackinac Straits Health System Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Saint Ignace, MI
  • NPI 1811152291
  NPD (past)
• Mercy Urgent Care

  • Urgent Care Clinic/Center
  • Muskegon, MI
  • NPI 1861432692

  Family Medicine

  NPD (past)
• West Shore Health Centers Corporation

  • Rural Health Clinic/Center
  • Onekama, MI
  • NPI 1063625192
  NPD (past)
• West Shore Health Centers Corporation

  • Rural Health Clinic/Center
  • Onekama, MI
  • NPI 1366515611
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1750484879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14734 PARK AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201927",
            "telephone_number": "231-547-6554",
            "fax_number": "231-547-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14734 PARK AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201927",
            "telephone_number": "231-547-6554",
            "fax_number": "231-547-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301076489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8002922550",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Simons, CRNA
• Elizabeth H. Simpson, M.A.
• Tracy Skinner, LMSW
• Charity Lynn Slough
• Joel E Smith, PT
• Cynthia Statler, M.D.
• Jeffrey K Steffey, RPH
• Tyler W Steffey, PHARMD
• Steven a Voci OD PC
• Emily K Stevens, LMSW

• Family Medicine Physician in Charlevoix, MI
• Providers in Charlevoix, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.