Individual provider Active NPI

Allison Leigh-Smith Rupp, DO

  • Internal Medicine Physician
  • Valdosta, GA
National Provider Identifier
1881269835
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
100111 Issued in GA
Practice address
2501 N Patterson St
Valdosta, GA 31602
Phone
(229) 433-1000
NPI assigned
May 21, 2021
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT020658 PA
Internal Medicine Physician 207R00000X 100111 GA Primary

Addresses

Primary practice location

2501 N Patterson St
Valdosta, GA 31602

Mailing address

4260 Nelson Hill PL
Hahira, GA 31632-3264
Phone (610) 715-9177

Other practice location 1

1500 Lansdowne Ave
Darby, PA 19023-1200
Phone (610) 237-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241017002422 GA Practitioner - Internal Medicine 3577953454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

116 W Thigpen Ave
Lakeland, GA 31635-1011
Phone (229) 433-8440

4256 N Valdosta Rd
Valdosta, GA 31602-6814
Phone (229) 242-1234

4274 N Valdosta Rd
Valdosta, GA 31602-6814
Phone (229) 242-1234

4280 N Valdosta Rd
Valdosta, GA 31602-6814
Phone (229) 433-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100111GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SGMC Affiliated Services LLC Current Accepting new patients
SGMC Physician Network Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

116 W Thigpen Ave
Ste D
Lakeland, GA 31635
Phone (229) 482-8585

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

410 Connell Rd
Ste T
Valdosta, GA 31602
Phone (229) 242-9565

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

Interoperability endpoints

  • Direct secure messaging: asmith2014503@direct.trinity-health.org

Organizations & group practices 2

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 2

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": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1881269835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4260 NELSON HILL PL",
            "city": "HAHIRA",
            "state": "GA",
            "postal_code": "316323264",
            "telephone_number": "610-715-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-433-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Lansdowne Ave",
            "address_purpose": "LOCATION",
            "city": "Darby",
            "state": "PA",
            "postal_code": "190231200",
            "country_code": "US",
            "telephone_number": "610-237-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUPP",
        "first_name": "ALLISON",
        "middle_name": "LEIGH-SMITH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT020658",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "100111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.