William J. Smith, DC., CCST

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

NM1130 Issued in NM

Practice address

1400 S Ave D
Portales, NM 88130-6886

Phone

(505) 356-4440

Fax

(505) 356-4433

NPI assigned

Jan 4, 2006

Last updated

Jul 14, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Smith Chiropractic Center PA

  • Chiropractor
  • Portales, NM
  • NPI 1386973790
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1851379499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S AVE D",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881306886",
            "telephone_number": "575-356-4440",
            "fax_number": "575-356-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S AVE D",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881306886",
            "telephone_number": "505-356-4440",
            "fax_number": "505-356-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILLIAM",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DC., CCST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NM",
            "license": "NM1130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN PROVIDER #",
            "identifier": "201009423",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K9129",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "NM01K995",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "350023553",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Lynn Simmons
• Smith Chiropractic Center PA
• Desiree I Smith, RN
• James Franklin Smith, DDS
• Makenzie Marie Smith
• Southeastern Behavioral Associates, LLC
• Erin Standefer, MSCCCSLP
• Aaron Mark Standing, DMD
• Jordan Stearns
• Sheila Ann Stephenson, LCSW

• Sports Physician Chiropractor in Portales, NM
• Providers in Portales, NM by specialty
• Sports Physician Chiropractor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.