Charlene Marie Smith, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

25 MA05076000 Issued in NJ

Practice address

18 Fairview Rd
Medford, NJ 08055-9116

Phone

(856) 797-9178

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

Yes

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

Enrolled in NJ

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lourdes Imaging Associates PA

  • Diagnostic Radiology Physician
  • Camden, NJ
  • NPI 1952330599
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1790876787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 FAIRVIEW RD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 FAIRVIEW RD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559116",
            "telephone_number": "856-797-9178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLENE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25 MA05076000",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD028614E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5322502",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Varunan Sivalingam, MD
• Sleep for Health-Medford LLC
• Mark R Slysh, DMD
• Morgan A Small
• Danielle J Smetts, OTR/L
• Erica Lynn Smith
• Jordan Alice Smith, PA-C
• Elizabeth Ann Smolsky, MSN, APN, C
• Heather Soellner
• South Jersey Dental Sleep Center LLC

• Diagnostic Radiology Physician in Medford, NJ
• Providers in Medford, NJ by specialty
• Diagnostic Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.