Leatha Michelle Smith, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA200643 Issued in LA

Practice address

1717 Oak Park Blvd FL 3
Lake Charles, LA 70601-8990

Phone

(337) 494-4900

Fax

(337) 494-4936

NPI assigned

Aug 1, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Calcasieu Cameron Emergency Physician Group LLC

  • Emergency Medicine Physician
  • Sulphur, LA
  • NPI 1699167478
  Medicare reassignment
• Eunice Emergency Group LLC

  • Emergency Medicine Physician
  • Eunice, LA
  • NPI 1104895689
  Medicare reassignment
• Lake Charles Medical Services Orthopedics Associates LLC

  • Orthopaedic Surgery Physician
  • Lake Charles, LA
  • NPI 1962695361
  Medicare reassignment

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1750713798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 OAK PARK BLVD FL 3",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018990",
            "telephone_number": "337-494-4900",
            "fax_number": "337-494-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 OAK PARK BLVD FL 3",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018990",
            "telephone_number": "337-494-4900",
            "fax_number": "337-494-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LEATHA",
        "middle_name": "MICHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA200643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley Brooke Smith
• Jairus James Matthew Smith, PHARM.D
• Jennifer Stewart Smith, OD
• Jerrold Walker Smith, RPH
• Lauren Lebert Smith, PHARMD
• Marlena Smith
• Mary Fiona Hendry Smith
• Shondra L. Smith, MD
• Tawana Smith, LCSW
• Ernest Clyde Smoot, MD

• Physician Assistant in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.