Individual provider Active NPI

Gary E Smith, MD

  • Emergency Medicine Physician
  • Jacksonville, TX
National Provider Identifier
1861434771
Registry record updated Feb 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
L0610 Issued in TX
Practice address
2024 S Jackson St
Jacksonville, TX 75766-5822
Phone
(903) 589-5768
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L0610 TX Primary

Addresses

Primary practice location

2024 S Jackson St
Jacksonville, TX 75766-5822

Mailing address

PO Box 8549
Fort Worth, TX 76124-0549
Phone (817) 451-4208

Other identifiers 2

IdentifierTypeStateIssuer
0063HROtherTXBCBS
141293406MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050916000602 TX Practitioner - Emergency MedicinePractitioner - Family Practice 3173556487 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
University of Missouri, Columbia School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians Southwest PAGroup PAC ID 1850204363, 188 clinicians

Practice addresses (Care Compare)

1000 S Beckham Ave
Tyler, TX 75701-1908
Phone (903) 597-0351

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L0610TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Oct 22, 2018 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Sep 1, 2008 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Oct 22, 2018 Accepting new patients
Emergency Physicians Medical Group Inc. Emergency Medicine Past Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

2000 S Palestine St
Athens, TX 75751
Phone (903) 675-2216

125 Newman St
Fairfield, TX 75840
Phone (888) 250-2326

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

501 S Ragsdale St
Jacksonville, TX 75766
Phone (903) 541-5000

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

2701 US Highway 271 N
Pittsburg, TX 75686
Phone (903) 946-5000

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

6210 S Broadway Ave
Tyler, TX 75703
Phone (903) 579-2700

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

Interoperability endpoints

  • Direct secure messaging: gsmith360230@ahs.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203120000000",
    "number": "1861434771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8549",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761240549",
            "telephone_number": "817-451-4208",
            "fax_number": "817-563-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 S JACKSON ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757665822",
            "telephone_number": "903-589-5768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GARY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L0610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0063HR",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141293406",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, TX

Sources for this page

Verify at the official NPI Registry.