Individual provider Active NPI

Stephen Wayne Smith, M.D.

  • Cardiovascular Disease Physician
  • Raleigh, NC
National Provider Identifier
1811960412
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
18719 Issued in NC
Practice address
4414 Lake Boone TRL Ste 505
Raleigh, NC 27607-7521
Phone
(919) 784-2300
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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 18719 NC
Cardiovascular Disease Physician 207RC0000X 18719 NC Primary

Addresses

Primary practice location

4414 Lake Boone TRL Ste 505
Raleigh, NC 27607-7521

Mailing address

4414 Lake Boone TRL Ste 505
Raleigh, NC 27607-7521
Phone (919) 784-2300

Other practice location 1

4420 Lake Boone Trl
Raleigh, NC 27607-7505
Phone (919) 784-3030

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssmith9288@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20100517000439 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2668500380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

4414 Lake Boone TRL
Suite 505
Raleigh, NC 27607-7521
Phone (919) 784-2300

Hospital & facility affiliations

  • Rex Hospital Hospital, Raleigh, NC, CCN 340114
  • Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18719NCMDProfessional Counselor
9300816NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC Cardiovascular Disease CurrentSince Jun 1, 2025 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Rex Hospital Inc Cardiovascular Disease Past Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
Mid-Atlantic Emergency Medical Associates, PLLC Past Accepting new patients

Locations

400 Health Park Dr
#120
Garner, NC 27529
Phone (919) 250-2260

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

4414 Lake Boone Trl
Ste 505
Raleigh, NC 27607
Phone (984) 974-0500

Interoperability endpoints

  • Direct secure messaging: ssmith9288@direct.unc.nchie.net

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1811960412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 505",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077521",
            "telephone_number": "919-784-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 505",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077521",
            "telephone_number": "919-784-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4420 Lake Boone Trl",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276077505",
            "country_code": "US",
            "telephone_number": "919-784-3030",
            "fax_number": "919-781-8729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "WAYNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "18719",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "18719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssmith9288@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4414 Lake Boone Trl Ste 505",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.