Individual provider Active NPI

Wesley Lincoln Smith, D.O.

  • Psychiatry Physician
  • Phoenix, AZ
National Provider Identifier
1841358223
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2616 Issued in AZ
Practice address
2500 E Van Buren St
Phoenix, AZ 85008-6037
Phone
(480) 695-6625
NPI assigned
Dec 5, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
621822MedicaidAZ
AZ0724670OtherBCBS

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
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc Emergency Medicine CurrentSince Feb 20, 2020 Accepting new patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc CurrentSince Feb 20, 2020 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.