Active NPI
Wesley Lincoln Smith, D.O.
- Psychiatry Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 2616
- Practice address
- 2500 E Van Buren St
Phoenix, AZ 85008-6037 - Phone
- (480) 695-6625
- NPI assigned
- Dec 5, 2006
- Last updated
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 2616 | AZ | |
| Forensic Psychiatry Physician | 2084F0202X | 2616 | AZ | |
| Psychiatry Physician | 2084P0800X | 2616 | AZ | Primary |
Addresses
Primary practice location
2500 E Van Buren St
Phoenix, AZ 85008-6037
Mailing address
2500 E Van Buren St
Phoenix, AZ 85008-6037
Phone (480) 695-6625
Other practice location 1
4212 N 16th St
Phoenix, AZ 85016-5319
Phone (602) 263-1508
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 621822 | Medicaid | AZ | |
| AZ0724670 | Other | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District Medical Group, Inc | Emergency Medicine | Current | Accepting new patients |
| District Medical Group, Inc | Current | Accepting new patients | |
| District Medical Group, Inc | Current | Accepting new patients | |
| Magellan Health Services of Arizona, Inc | Past | Accepting new patients | |
| Vo of Arizona, Inc. | Past | Accepting new patients |
Locations
570 W Brown Rd
Mesa, AZ 85201
Phone (480) 344-2000
2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043
3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520
5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000
Interoperability endpoints
- wsmith69907@direct.valleywisehealth.org
Organizations & group practices 5
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1841358223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 E VAN BUREN ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850086037",
"telephone_number": "480-695-6625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 E VAN BUREN ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850086037",
"telephone_number": "480-695-6625"
}
],
"practiceLocations": [
{
"address_1": "4212 N 16th St",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850165319",
"country_code": "US",
"telephone_number": "602-263-1508",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "WESLEY",
"middle_name": "LINCOLN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AZ",
"license": "2616",
"primary": false
},
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "AZ",
"license": "2616",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AZ",
"license": "2616",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "621822",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "AZ0724670",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.