Active NPI
Raymond Lee Smith, DPM
- Foot & Ankle Surgery Podiatrist
- Edmond, OK
National Provider Identifier
1891794715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 178
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200223730A | Medicaid | OK | |
| 100780200A | Medicaid | OK |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090127000350 | OK | Practitioner - Podiatry | 4486692175 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178 | OK | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edmond Podiatry Associates LLC | Current | 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
- 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.
-
dba Central Oklahoma Foot and Ankle Center of Edmond
- Clinic/Center
- Edmond, OK
- NPI 1033362231
-
- Podiatrist
- Edmond, OK
- NPI 1245336015
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.