Bryan Wesley Smith, M.D.

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

34586 Issued in SC

Practice address

1409 Devine St
Columbia, SC 29208-3902

Phone

(803) 777-2913

Fax

(803) 777-0126

NPI assigned

May 21, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Thomson Student Health Center

  • Clinic/Center
  • Columbia, SC
  • NPI 1326167537
  NPD (past)

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1790045094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 DEVINE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292083902",
            "telephone_number": "803-777-2913",
            "fax_number": "803-777-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 DEVINE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292083902",
            "telephone_number": "803-777-2913",
            "fax_number": "803-777-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRYAN",
        "middle_name": "WESLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "SC",
            "license": "34586",
            "primary": true
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "NC",
            "license": "39745",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7977421",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ayanna Smith, MA, CCC-SLP
• Brian A Smith, MD
• Brittney Smith, FNP
• Brittney Victoria Smith, MSW
• Brodrick Darren Smith, APRN
• Chandler Elizabeth Smith, RT
• Chase Smith
• Cherish Hoover Smith
• Christine Glen Smith
• Cindy S Smith, LPC

• Pediatric Sports Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Pediatric Sports Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.

Verify at the official NPI Registry.