Individual provider Active NPI

William Robert Smith Jr., MD

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1891795910
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
030894 Issued in GA
Practice address
1140 Hammond Dr NE
Suite E5250
Atlanta, GA 30328-5338
Phone
(404) 256-2688
Fax
(404) 256-1820
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 030894 GA Primary

Addresses

Primary practice location

1140 Hammond Dr NE
Suite E5250
Atlanta, GA 30328-5338

Mailing address

333 Sandy Springs Cir NE
Suite 207
Atlanta, GA 30328-3897
Phone (404) 705-8990

Other identifiers 1

IdentifierTypeStateIssuer
00393775DMedicaidGA

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
I20151218001613 GA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 3173824091 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030894GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC CurrentSince Dec 1, 2015 Accepting new patients
Northside Pediatrics & Adolescent Medicine PC Pediatrics Past Accepting new patients

Locations

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

Interoperability endpoints

  • Direct secure messaging: wsmith4438@choa.gadirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1891795910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SANDY SPRINGS CIR NE",
            "address_2": "SUITE 207",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283897",
            "telephone_number": "404-705-8990",
            "fax_number": "404-705-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 HAMMOND DR NE",
            "address_2": "SUITE E5250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285338",
            "telephone_number": "404-256-2688",
            "fax_number": "404-256-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "030894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00393775D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.