Tyler Office of Pediatrics P a

Primary specialty

SpecialistTaxonomy code 174400000X

License

J4527 Issued in TX

Legal business name

TYLER OFFICE OF PEDIATRICS P A

Practice address

4801 Troup Hwy
Suite 301
Tyler, TX 75703-2356

Phone

(903) 595-3220

Fax

(903) 595-3887

NPI assigned

Dec 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey P Smith, M.D.NPI 1760578835

Title

Owner/Physician

Phone

(903) 595-3220

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey P. Smith, M.D.

  • Pediatrics Physician
  • Tyler, TX
  • NPI 1760578835

  Specialist

  NPD Authorized official
• Nancy Caroline McRae-Vogler, M.D.

  • Pediatrics Physician
  • Tyler, TX
  • NPI 1649364241

  Specialist

  NPD (past)

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1851574032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131866",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757131866",
            "telephone_number": "903-595-3220",
            "fax_number": "903-595-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 TROUP HWY",
            "address_2": "SUITE 301",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032356",
            "telephone_number": "903-595-3220",
            "fax_number": "903-595-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER OFFICE OF PEDIATRICS P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "903-595-3220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "J4527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118586004",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043902803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Tyler, TX
• Providers in Tyler, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.