NPIMap

Organization Active NPI

Smithson Valley Family Medicine, LLP

  • Family Medicine Physician
  • Spring Branch, TX
National Provider Identifier
1841322013
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K5049 Issued in TX
Legal business name
SMITHSON VALLEY FAMILY MEDICINE, LLP
Practice address
6098 FM 311
Smithson Valley Family Medicine
Spring Branch, TX 78070-7253
Phone
(830) 885-5541
Fax
(830) 885-5542
NPI assigned
Mar 12, 2007
Last updated
May 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Matthew W Nicola, MDNPI 1124096581
Title
Owner
Phone
(830) 885-5541

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X K5049 TX Primary

Addresses

Primary practice location

6098 FM 311
Smithson Valley Family Medicine
Spring Branch, TX 78070-7253

Mailing address

6098 FM 311
Smithson Valley Family Medicine
Spring Branch, TX 78070-7253
Phone (830) 885-5541

Other identifiers 2

IdentifierTypeStateIssuer
178787102MedicaidTX
169864902MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060126000994 TX Part B Supplier - Clinic/Group Practice 3779597927 Receives reassigned benefits from 12 practitioners
Practice locations: Canyon Lake, TX; Spring Branch, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1031488Smithson Valley Family Medicine Assoc6098 FM 311, Spring Branch, TX 78070Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory

Locations

13201 FM 306
Canyon Lake, TX 78133
Phone (830) 964-5575

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1841322013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6098 FM 311",
            "address_2": "SMITHSON VALLEY FAMILY MEDICINE",
            "city": "SPRING BRANCH",
            "state": "TX",
            "postal_code": "780707253",
            "telephone_number": "830-885-5541",
            "fax_number": "830-885-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6098 FM 311",
            "address_2": "SMITHSON VALLEY FAMILY MEDICINE",
            "city": "SPRING BRANCH",
            "state": "TX",
            "postal_code": "780707253",
            "telephone_number": "830-885-5541",
            "fax_number": "830-885-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHSON VALLEY FAMILY MEDICINE, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "NICOLA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-885-5541",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K5049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178787102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169864902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Branch, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.