NPIMap

Individual provider Active NPI

Cleatious David Smith, MD

  • Family Medicine Physician
  • Jay, FL
National Provider Identifier
1871546515
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME36891 Issued in FL
Practice address
14088 Alabama St
Jay, FL 32565
Phone
(850) 675-4546
Fax
(850) 675-4548
NPI assigned
May 17, 2006
Last updated
Dec 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME36891 FL Primary

Addresses

Primary practice location

14088 Alabama St
Jay, FL 32565

Mailing address

PO Box 10
14088 Alabama St
Jay, FL 32565
Phone (850) 675-4546

Other identifiers 29

IdentifierTypeStateIssuer
0166758OtherFLUNITED HEALTHCARE
039350900MedicaidFL
5309586OtherFLAETNA
5309586OtherFLAETNA GLOBAL BENEFITS
N146OtherFLWELLCARE
541009001OtherALALACAID
593216460A06OtherFLMEDICAL MUTUAL
660022102MedicaidFL
P00017879OtherFLRAILROAD MEDICARE
1871546515OtherFLPYRAMID CLAIMS
57089OtherFLPREFERRED PATIENT CARE
000800449OtherALALACAID
051128OtherFLVISTA
1050038OtherFLCIGNA INTERNATIONAL
1050038OtherFLCIGNA HEALTHCARE
21333OtherBLUE CROSS AND BLUE SHIELD OF FLORIDA
57089OtherFLBLUE CROSS AND BLUE SHIELD OF FLORIDA
0166758OtherFLUNITED HEALTHCARE OF FLORIDA
592014611BOtherFLHUMANA CLAIMS OFFICE
592014611BOtherFLHUMANA/EMPLOYERS HEALTH
A093OtherFLHEALTH FIRST NETWORK
21333OtherFLADVANTAGE 65
5309586OtherFLAETNA US HEALTHCARE
57089OtherFLHEALTH 1ST NETWORK, INC.
59024373OtherALBLUE CROSS AND BLUE SHIELD OF ALABAMA
59116861OtherALBLUE CROSS AND BLUE SHIELD OF ALABAMA
0166758OtherFLDEFINITY HEALTH CLAIMS
21333OtherFLBLUE MEDICARE ADVANTAGE
660022100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051103000559 FL Practitioner - Family Practice 1951398213 Reassigns benefits to 2 organizations
Practice locations: Jay, FL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Panhandle Rural Health IncorporatedGroup PAC ID 1557358801, 5 clinicians

Practice addresses (Care Compare)

14088 Alabama St
Jay, FL 32565-1036
Phone (850) 675-4546

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Panhandle Rural Health Incorporated CurrentSince Feb 1, 1994 Accepting new patients
J S Michael Smith MD PA Family Medicine Current Accepting new patients
Jay Hospital, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Jeffery S Kelley MD Current Accepting new patients
Jay Hospital, Inc. CurrentSince Mar 1, 2020 Accepting new patients

Locations

14088 Alabama St
Jay, FL 32565
Phone (850) 675-4546

14114 Alabama St
Jay, FL 32565
Phone (850) 675-8000

Interoperability endpoints

  • Direct secure messaging: david.smith@jaymedical.directbygreenway.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jay Medical ClinicJay, FL, CCN 103858 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 1994

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1871546515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "address_2": "14088 ALABAMA ST",
            "city": "JAY",
            "state": "FL",
            "postal_code": "32565",
            "telephone_number": "850-675-4546",
            "fax_number": "850-675-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14088 ALABAMA ST",
            "city": "JAY",
            "state": "FL",
            "postal_code": "32565",
            "telephone_number": "850-675-4546",
            "fax_number": "850-675-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CLEATIOUS",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME36891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0166758",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039350900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5309586",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GLOBAL BENEFITS",
            "identifier": "5309586",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "N146",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALACAID",
            "identifier": "541009001",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "593216460A06",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660022102",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00017879",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PYRAMID CLAIMS",
            "identifier": "1871546515",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED PATIENT CARE",
            "identifier": "57089",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALACAID",
            "identifier": "000800449",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISTA",
            "identifier": "051128",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA INTERNATIONAL",
            "identifier": "1050038",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "1050038",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF FLORIDA",
            "identifier": "21333",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF FLORIDA",
            "identifier": "57089",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE OF FLORIDA",
            "identifier": "0166758",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA CLAIMS OFFICE",
            "identifier": "592014611B",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA/EMPLOYERS HEALTH",
            "identifier": "592014611B",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FIRST NETWORK",
            "identifier": "A093",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTAGE 65",
            "identifier": "21333",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "5309586",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH 1ST NETWORK, INC.",
            "identifier": "57089",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF ALABAMA",
            "identifier": "59024373",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF ALABAMA",
            "identifier": "59116861",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEFINITY HEALTH CLAIMS",
            "identifier": "0166758",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE MEDICARE ADVANTAGE",
            "identifier": "21333",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660022100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jay, FL

Sources for this page

Verify at the official NPI Registry.