Individual provider Active NPI

Aubrey Smith, LOP

  • Prosthetist
  • Canton, GA
National Provider Identifier
1770640633
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
012 Issued in GA
Practice address
95 Hickory Springs Ind Dr
Canton, GA 30115-7933
Phone
(770) 345-6899
Fax
(770) 345-7341
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X 012 GA
Prosthetist 224P00000X 012 GA Primary

Addresses

Primary practice location

95 Hickory Springs Ind Dr
Canton, GA 30115-7933

Mailing address

95 Hickory Springs Ind Dr
Canton, GA 30115-7933
Phone (770) 345-6899

Other identifiers 1

IdentifierTypeStateIssuer
7700620MedicaidNC

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
012GAMDProsthetist

Practice roles

OrganizationSpecialtyStatusNew patients
United Artificial Limb Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1770640633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 HICKORY SPRINGS IND DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157933",
            "telephone_number": "770-345-6899",
            "fax_number": "770-345-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 HICKORY SPRINGS IND DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157933",
            "telephone_number": "770-345-6899",
            "fax_number": "770-345-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AUBREY",
        "name_prefix": "Mr.",
        "credential": "LOP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "GA",
            "license": "012",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "GA",
            "license": "012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7700620",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.