Active NPI
Garwin Allen Smith, CO/LO (ABC CERTIFIED
- Orthotist
- Tyler, TX
National Provider Identifier
1831249903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- 307
- Practice address
- 2726 Fairfax Dr
Tyler, TX 75701-6504 - Phone
- (903) 520-1923
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | 307 | TX | Primary |
Addresses
Primary practice location
2726 Fairfax Dr
Tyler, TX 75701-6504
Mailing address
2726 Fairfax Dr
Tyler, TX 75701-6504
Phone (903) 520-1923
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CSHCN079443001 | Medicaid | TX | |
| 079443001 | Other | TX | CSHCN-ORTHOTICS PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psi Premier Specialties, Inc. | Orthotist | Past | Accepting new patients |
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": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572566400000",
"number": "1831249903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2726 FAIRFAX DR",
"city": "TYLER",
"state": "TX",
"postal_code": "757016504",
"telephone_number": "903-520-1923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2726 FAIRFAX DR",
"city": "TYLER",
"state": "TX",
"postal_code": "757016504",
"telephone_number": "903-520-1923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "GARWIN",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "CO/LO (ABC CERTIFIED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2019-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "TX",
"license": "307",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CSHCN079443001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CSHCN-ORTHOTICS PROVIDER",
"identifier": "079443001",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.