Individual provider Active NPI

Raymond Lee Smith, DPM

  • Foot & Ankle Surgery Podiatrist
  • Edmond, OK
National Provider Identifier
1891794715
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
178 Issued in OK
Practice address
1404 E 9TH St
Edmond, OK 73034-5712
Phone
(405) 285-8538
Fax
(405) 285-8539
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 178 OK
Foot & Ankle Surgery Podiatrist 213ES0103X 178 OK Primary

Addresses

Primary practice location

1404 E 9TH St
Edmond, OK 73034-5712

Mailing address

4900 S Monaco St
#210
Denver, CO 80237-3486
Phone (405) 285-8538

Other identifiers 2

IdentifierTypeStateIssuer
200223730AMedicaidOK
100780200AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090127000350 OK Practitioner - Podiatry 4486692175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178OKMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edmond Podiatry Associates LLC CurrentSince Nov 1, 2008 Accepting new patients
Dr Raymond L Smith PC Podiatrist Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1404 E 9th St
Edmond, OK 73034
Phone (405) 285-8538

105 S Bryant Ave
Ste 104
Edmond, OK 73034
Phone (405) 216-0956

Interoperability endpoints

  • Direct secure messaging: rsmith27238@ouhealth.direct-ci.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1891794715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST",
            "address_2": "#210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373486",
            "telephone_number": "405-285-8538",
            "fax_number": "405-285-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 E 9TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345712",
            "telephone_number": "405-285-8538",
            "fax_number": "405-285-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RAYMOND",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OK",
            "license": "178",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200223730A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100780200A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.