Smith Clinic LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SMITH CLINIC LLC

Practice address

5116 Northwind Blvd
Valdosta, GA 31605-7672

Phone

(229) 261-9500

Fax

(229) 261-9501

NPI assigned

May 28, 2019

Organization subpart

No

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

Authorized official

Name

Larry E Smith, MDNPI 1548297195

Title

Owner

Phone

(229) 261-9500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larry E Smith, M.D.

  • Internal Medicine Physician
  • Valdosta, GA
  • NPI 1548297195

  GA, Internal Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559001600000",
    "number": "1780241505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 NORTHWIND BLVD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316057672",
            "telephone_number": "229-261-9500",
            "fax_number": "229-261-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5116 NORTHWIND BLVD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316057672",
            "telephone_number": "229-261-9500",
            "fax_number": "229-261-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-28",
        "last_updated": "2019-05-28",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-261-9500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Valdosta, GA
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.