Shelly Cooper Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-03378 Issued in NC

Practice address

240 Highway 105 Ext Ste 100
Boone, NC 28607-4291

Phone

(828) 264-7311

Fax

(828) 264-7907

NPI assigned

Apr 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

High Country Community HealthGroup PAC ID 8628225190, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Watauga Medical Center Hospital, Boone, NC, CCN 340051

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJJEBD

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.

• High Country Community Health

  dba High Country Community Health Primedical

  • Federally Qualified Health Center (FQHC)
  • Boone, NC
  • NPI 1518620665
  Medicare reassignment Care Compare group NPD
• High Country Community Health

  • Federally Qualified Health Center (FQHC)
  • Mount Airy, NC
  • NPI 1629942115
  NPD
• High Country Community Health

  • Federally Qualified Health Center (FQHC)
  • Newland, NC
  • NPI 1083979082

  Family Medicine

  NPD (past)

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

• Watauga Medical Center Inc

  dba Watauga Medical Center

  • General Acute Care Hospital
  • Boone, NC
  • NPI 1205859766
  Care Compare affiliation

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1891053872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1490",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286071490",
            "telephone_number": "828-264-7311",
            "fax_number": "828-264-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HIGHWAY 105 EXT STE 100",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074291",
            "telephone_number": "828-264-7311",
            "fax_number": "828-264-7907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Meeting St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286553594",
            "country_code": "US",
            "telephone_number": "828-608-0800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1925 N Bridge St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Elkin",
            "state": "NC",
            "postal_code": "286212105",
            "country_code": "US",
            "telephone_number": "336-835-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "560 Malcolm Blvd",
            "address_purpose": "LOCATION",
            "city": "Connelly Springs",
            "state": "NC",
            "postal_code": "286127918",
            "country_code": "US",
            "telephone_number": "828-874-2061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "935 State Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "NC",
            "postal_code": "286074948",
            "country_code": "US",
            "telephone_number": "828-262-3886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "448 Cranberry St",
            "address_purpose": "LOCATION",
            "city": "Newland",
            "state": "NC",
            "postal_code": "286578800",
            "country_code": "US",
            "telephone_number": "828-737-0221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHELLY",
        "middle_name": "COOPER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-03378",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-03378",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Elizabeth Smith, LCSW-A
• Dillon Edward Smith, MS, SCAT, ATC, PES
• Jerica Suzanne Smith, F.N.P-C
• Justin Adam Smith, ATC
• Roderick Lee Smith Jr., CCC-SLP
• Ashley Snedeger
• Julia Tyson Snyder, D.D.S.
• Lucyna Maria Sonek, LPC, LCAS
• Southmountain Children and Family Services (Children's Advocacy Center of the Blue Ridge)
• Southmountain Children and Family Services

• Physician Assistant in Boone, NC
• Providers in Boone, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.