Individual provider Active NPI

Richard C Smith, MD

  • Diagnostic Radiology Physician
  • Lake Village, AR
National Provider Identifier
1831206515
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
E-6378 Issued in AR
Practice address
2729 S Highway 65 82
Lake Village, AR 71653-6136
Phone
(870) 632-9091
Fax
(662) 537-4888
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 15057 MS
Diagnostic Radiology Physician 2085R0202X E-6378 AR Primary

Addresses

Primary practice location

2729 S Highway 65 82
Lake Village, AR 71653-6136

Mailing address

755 S Washington Ave
Greenville, MS 38701-5832
Phone (870) 632-9091

Other identifiers 4

IdentifierTypeStateIssuer
P00316066OtherRR MEDICARE
1538043MedicaidLA
140263001MedicaidAR
00334503MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110921000405 AL Practitioner - Diagnostic Radiology 7214994821 Reassigns benefits to 2 organizations
I20180305001448 FL Practitioner - Diagnostic Radiology 7214994821 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

1045 Golf Valley Dr
Apopka, FL 32712-2593
Phone (866) 722-1655

144 Intracoastal Dr
Madison, AL 35758-9424
Phone (904) 399-5550

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

2115 Little Rd
Trinity, FL 34655-4410
Phone (904) 399-5550

2626 Capital Medical Blvd
Tallahassee, FL 32308-4402
Phone (904) 399-5550

611 Zeagler Dr
Palatka, FL 32177-3810
Phone (904) 399-5550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.06 of 100Reported as group
Quality
72.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-6378ARMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Radiology Services of Central Florida Inc Diagnostic Radiology Current Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince May 26, 2023 Accepting new patients
Northside Radiology Associates LLC Diagnostic Radiology CurrentSince Feb 2, 2025 Accepting new patients
Cape Radiology Group, P.C. Diagnostic Radiology Past Accepting new patients
Radiology & Imaging Specialists, P.C. Diagnostic Radiology Past Accepting new patients
Delta Medical Group Diagnostic Radiology Past Accepting new patients
Missouri Medical Imaging, Inc. Diagnostic Radiology Past Accepting new patients
Delta Physician Practices Past Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

502 W Highland Blvd
Inverness, FL 34452
Phone (352) 344-6481

1100 NW 95th St
Miami Shores, FL 33150
Phone (305) 835-6000

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

611 Zeagler Dr
Palatka, FL 32177
Phone (386) 326-8070

809 E Marion Ave
Punta Gorda, FL 33950
Phone (941) 625-1951

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

3600 S Highlands Ave
Sebring, FL 33870
Phone (863) 385-6101

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272931200000",
    "number": "1831206515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S WASHINGTON AVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387015832",
            "telephone_number": "870-632-9091",
            "fax_number": "662-537-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2729 S HIGHWAY 65 82",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716536136",
            "telephone_number": "870-632-9091",
            "fax_number": "662-537-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RICHARD",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "15057",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E-6378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00316066",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538043",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140263001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00334503",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Village, AR

Sources for this page

Verify at the official NPI Registry.