Individual provider Active NPI

Catherine S Smith, MD

  • Otolaryngology Physician
  • Punta Gorda, FL
National Provider Identifier
1851351407
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME138387 Issued in FL
Practice address
713 E Marion Ave Ste 133
Punta Gorda, FL 33950-3868
Phone
(941) 833-1777
Fax
(941) 347-8544
NPI assigned
Mar 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0101225426 VA
Otolaryngology Physician 207Y00000X ME138387 FL Primary

Addresses

Primary practice location

713 E Marion Ave Ste 133
Punta Gorda, FL 33950-3868

Mailing address

713 E Marion Ave Ste 133
Punta Gorda, FL 33950-3868
Phone (941) 833-1777

Other identifiers 1

IdentifierTypeStateIssuer
010148987MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address catherine.smith.1@4692.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20040806000035 VA Practitioner - Otolaryngology 3577535061 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME138387FLMDOtolaryngology Physician
0101225426VAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Memorial Hospital, Inc. CurrentSince Dec 1, 2017 Accepting new patients
Shenandoah Memorial Hospital, Inc. Otolaryngology CurrentSince Feb 9, 2019 Accepting new patients
Shenandoah Memorial Hospital, Inc. CurrentSince Dec 1, 2017 Accepting new patients
Shenandoah Head and Neck Specialists, PLC Otolaryngology CurrentSince Apr 4, 2005 Accepting new patients
Winchester Ear, Nose & Throat Center, PLLC Past Accepting new patients

Locations

142 Linden Dr
Ste 106
Winchester, VA 22601
Phone (540) 722-3878

347 Westside Station Dr
Winchester, VA 22601
Phone (540) 667-9252

136 Linden Dr
Ste 104
Winchester, VA 22601

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

240 Shenandoah St
Woodstock, VA 22664
Phone (540) 459-2808

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1851351407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 E MARION AVE STE 133",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503868",
            "telephone_number": "941-833-1777",
            "fax_number": "941-347-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 E MARION AVE STE 133",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503868",
            "telephone_number": "941-833-1777",
            "fax_number": "941-347-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CATHERINE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101225426",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME138387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010148987",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "catherine.smith.1@4692.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct address",
            "address_1": "713 E Marion Ave Ste 133",
            "city": "Punta Gorda",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339503868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

Verify at the official NPI Registry.