Individual provider Active NPI

Leah Nichole Smith, M.D.

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1841630076
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22496 Issued in MS
Practice address
3502 W Northside Dr
Jackson, MS 39213-4454
Phone
(601) 362-5321
NPI assigned
Jul 2, 2013
Last updated
Oct 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22496 MS Primary
Pediatrics Physician 208000000X 22496 MS

Addresses

Primary practice location

3502 W Northside Dr
Jackson, MS 39213-4454

Mailing address

3502 W Northside Dr
Jackson, MS 39213-4454
Phone (601) 362-5321

Other identifiers 1

IdentifierTypeStateIssuer
04801059MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140210001736 MS Practitioner - Obstetrics/Gynecology 1557590726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Tennessee, HSC, College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3502 W Northside Dr
Jackson, MS 39213-4454
Phone (601) 362-5321

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Mississippi Civic Improvement Association, Inc CurrentSince Sep 21, 2013 Accepting new patients
Central Mississippi Civic Improvement Association, Inc. CurrentSince Sep 21, 2013 Accepting new patients

Locations

145 Raymond Rd
Jackson, MS 39204
Phone (601) 372-1800

3502 W Northside Dr
Jackson, MS 39213
Phone (601) 982-1625

129 White Oak St
Utica, MS 39175
Phone (601) 885-6021

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1841630076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 W NORTHSIDE DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392134454",
            "telephone_number": "601-362-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LEAH",
        "middle_name": "NICHOLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "22496",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "22496",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04801059",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.