Individual provider Active NPI

Gary Smith, D.O.

  • Internal Medicine Physician
  • Pensacola, FL
National Provider Identifier
1811930266
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS13799 Issued in FL
Practice address
5151 N 9TH Ave
SHMG Hospitalist
Pensacola, FL 32504-8721
Phone
(850) 416-7619
Fax
(850) 416-7753
NPI assigned
Jun 14, 2006
Last updated
May 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD01697 TN
Internal Medicine Physician 207R00000X OS13799 FL Primary

Addresses

Primary practice location

5151 N 9TH Ave
SHMG Hospitalist
Pensacola, FL 32504-8721

Mailing address

PO Box 2699
Attn: SHMG/Hpe
Pensacola, FL 32513-2699
Phone (850) 416-7619

Other identifiers 2

IdentifierTypeStateIssuer
010167337MedicaidVA
0167370-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160502000753 FL Practitioner - HospitalistPractitioner - Internal Medicine 9133027584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
West Virginia School of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

123 Baptist Way
Pensacola, FL 32503-2254
Phone (850) 469-2313

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1697TNMDMarriage & Family Therapist
1978WVMDGeneral Practice Dentistry
OS13799FLMDInternal Medicine Physician
MD01697TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pensacola Hospitalist Physicians, LLC CurrentSince Jan 1, 2021 Accepting new patients
Pensacola Hospitalist Physicians, LLC CurrentSince Jan 1, 2021 Accepting new patients
Hni Medical Services of Florida, LLC Internal Medicine CurrentSince Jun 1, 2020 Accepting new patients
Bristol Consultants PC Internal Medicine CurrentSince May 24, 2005 Accepting new patients
East Tennessee Hematology/Oncology Assoc P.C. Past Accepting new patients
Premier Medical Group, Inc. Past Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

1000 W Moreno St
Pensacola, FL 32501
Phone (850) 434-4011

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1 Medical Park Blvd
Ste 350W
Bristol, TN 37620
Phone (423) 844-4240

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1811930266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "address_2": "ATTN: SHMG/HPE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-416-7619",
            "fax_number": "850-416-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N 9TH AVE",
            "address_2": "SHMG HOSPITALIST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048721",
            "telephone_number": "850-416-7619",
            "fax_number": "850-416-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GARY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD01697",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS13799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010167337",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0167370-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.