NPIMap

Individual provider Active NPI

Jacqueline Smith, M.D.

  • Diagnostic Radiology Physician
  • Thomasville, GA
National Provider Identifier
1831145994
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
056923 Issued in GA
Practice address
915 Gordon Ave
Thomasville, GA 31792-6614
Phone
(229) 228-2000
NPI assigned
May 26, 2006
Last updated
May 8, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 056923 GA Primary

Addresses

Primary practice location

915 Gordon Ave
Thomasville, GA 31792-6614

Mailing address

920 Cairo Rd
Thomasville, GA 31792-4255
Phone (229) 228-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060621000308 GA Practitioner - Diagnostic Radiology 0244223329 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Virginia Commonwealth University, School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grady General HospitalGroup PAC ID 7618866518, 31 clinicians
Brooks County HospitalGroup PAC ID 1557279049, 18 clinicians

Practice addresses (Care Compare)

1155 5TH St SE
Cairo, GA 39828-3142
Phone (229) 377-1150

2705 E Pinetree Blvd
Suite a
Thomasville, GA 31792-4875
Phone (229) 228-2000

90 E Stephens St
Camilla, GA 31730-1836
Phone (229) 336-5284

903 N Court St
Quitman, GA 31643-1315
Phone (229) 263-4171

915 Gordon Ave
Thomasville, GA 31792-6614
Phone (229) 228-2000

919 S Broad St
Thomasville, GA 31792-6114
Phone (229) 228-2970

947 S Broad St
Thomasville, GA 31792-6161
Phone (229) 228-3710

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grady General Hospital CurrentSince Mar 5, 2006 Accepting new patients
John D Archbold Memorial Hospital Inc CurrentSince Mar 13, 2006 Accepting new patients
Brooks County Hospital CurrentSince Mar 5, 2006 Accepting new patients
Pathology Associates, P.C. Current Accepting new patients
Hospital Authority of Mitchell County CurrentSince Mar 5, 2006 Accepting new patients
John D. Archbold Memorial Hospital, Inc. Diagnostic Radiology CurrentSince Mar 13, 2006 Accepting new patients
Radiology Associates of Milwaukee, S.C. Diagnostic Radiology Past Accepting new patients
Wisconsin Health Fund Past Accepting new patients

Locations

1155 5th St SE
Cairo, GA 39828
Phone (229) 226-3060

90 E Stephens St
Camilla, GA 31730
Phone (229) 200-4950

903 N Court St
Quitman, GA 31643
Phone (229) 263-4531

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

920 Cairo Rd
Thomasville, GA 31792
Phone (229) 228-8800

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/66097e3b-7cef-4b96-acca-38bfaae85903/

Organizations & group practices 8

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 6

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1831145994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255",
            "telephone_number": "229-228-8800",
            "fax_number": "229-228-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926614",
            "telephone_number": "229-228-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "056923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.