Wilson P Smith Jr MD PA

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

10510 Issued in SC

Legal business name

WILSON P SMITH JR MD PA

Practice address

2030 North Church Place
Spartanburg, SC 29303-2706

Phone

(864) 582-6858

Fax

(864) 585-0999

NPI assigned

Feb 7, 2007

Last updated

Jun 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Darla M Brown, RRT

Title

Office Manager

Phone

(864) 582-6858

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wilson P Smith Jr., MD

  • Pulmonary Disease Physician
  • Spartanburg, SC
  • NPI 1982675625

  Critical Care Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1851431928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4276",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293054276",
            "telephone_number": "864-582-6858",
            "fax_number": "864-585-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 NORTH CHURCH PLACE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293032706",
            "telephone_number": "864-582-6858",
            "fax_number": "864-585-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON P SMITH JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DARLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "864-582-6858",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RRT"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "10510",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "10510",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "SC",
            "license": "10510",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105102",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DG1464",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tisha Abercrombie Williams, M.D.
• Heather Nicole Williamson
• James A Williamson, CPOA
• Jim Williamson
• Jennifer Willis
• Amber Wilson
• Bethany McKinney Wilson, APRN
• Dana Hope Wilson, NNP
• Evelyn Foster Wilson, EDD, MHS, NRP, NCEE
• Janet Leahy Wilson, PA-C

• Critical Care Medicine (Internal Medicine) Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Critical Care Medicine (Internal Medicine) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.