Individual provider Active NPI

Charles D Smith, MD

  • Neurology Physician
  • Lexington, KY
National Provider Identifier
1831137041
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25444 Issued in KY
Practice address
740 S Limestone
J 401
Lexington, KY 40536-0284
Phone
(859) 323-5661
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25444 KY Primary
Neuroradiology Physician 2085N0700X 25444 KY
Diagnostic Radiology Physician 2085R0202X 25444 KY

Addresses

Primary practice location

740 S Limestone
J 401
Lexington, KY 40536-0284

Mailing address

740 S Limestone
J 401
Lexington, KY 40536-0284
Phone (859) 323-5661

Other identifiers 1

IdentifierTypeStateIssuer
64254444MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20050404000057 KY Practitioner - Neurology 2466409354 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25444KYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc Neurology CurrentSince Oct 15, 2004 Accepting new patients

Locations

175 Medical Heights Dr
Frankfort, KY 40601
Phone (502) 223-5641

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

217 Elm Tree Ln
Lexington, KY 40507
Phone (859) 257-8801

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1831137041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "address_2": "J 401",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360284",
            "telephone_number": "859-323-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "address_2": "J 401",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360284",
            "telephone_number": "859-323-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "25444",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "KY",
            "license": "25444",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "25444",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64254444",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.