Michael J Smith, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

036141508 Issued in IL

Practice address

611 W Park St
Emergency Med.
Urbana, IL 61801-2529

Phone

(217) 383-3313

Fax

(217) 383-4014

NPI assigned

Jul 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msmithmd220333@carlehiedirect.net

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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947

  Emergency Medicine

  Medicare reassignment NPD
• Kirby Medical Center

  • Family Medicine Physician
  • Monticello, IL
  • NPI 1386635373
  Medicare reassignment NPD
• Kirby Medical Center

  • Critical Access Hospital
  • Monticello, IL
  • NPI 1730179847
  Medicare reassignment
• Kirby Medical Center

  • Community/Retail Pharmacy
  • Monticello, IL
  • NPI 1568074714
  NPD
• Kirby Medical Center

  • Land Ambulance
  • Monticello, IL
  • NPI 1598869133
  NPD
• Medical Emergency Treatment Corporation

  • Emergency Medicine Physician
  • Maumee, OH
  • NPI 1437111861
  NPD (past)
• Reid Hospital & Health Care Services Inc

  • Internal Medicine Physician
  • Richmond, IN
  • NPI 1982633236
  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1861491599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "EMERGENCY MED.",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-3313",
            "fax_number": "217-383-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01063120",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036141508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000517783",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200858510",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Francis Smith, M.D.
• Emily Danielle Smith, RNC-NIC
• Kathy L Smith, NP
• Kimberly Smith, NP
• Melissa Y Smith, CRNA
• Bridget Leigh Sneed
• Grace Emily Yajun Snider
• Elizabeth Rae Snowden, CRNA
• Elizabeth S Solava, PT
• Jasmine Solis, MSW

• Emergency Medical Services (Emergency Medicine) Physician in Urbana, IL
• Providers in Urbana, IL by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.