Stephen C Smith, M.A., PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2783 Issued in TN

Practice address

2035 E Stonebrook PL
Kingsport, TN 37660-4000

Phone

(423) 282-1480

Fax

(423) 928-1353

NPI assigned

Oct 17, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Wright State University Boonshoft School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BH Services Southeast 1 PCGroup PAC ID 7012457054, 96 clinicians

Ipc Pac Healthcare Services of Tennessee PCGroup PAC ID 0840587572, 74 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• BH Services Southeast 1 PC

  • Nurse Practitioner
  • Brownsville, TN
  • NPI 1164251526
  Medicare reassignment Care Compare group NPD
• Ipc Pac Healthcare Services of Tennessee PC

  • Internal Medicine Physician
  • Bristol, TN
  • NPI 1104277656
  Medicare reassignment Care Compare group NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441
  Medicare reassignment NPD
• CS Pacs 3 Southeast, LLC

  • Hospitalist Physician
  • Bluefield, WV
  • NPI 1154104958

  TN

  Medicare reassignment NPD
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809

  TN

  Medicare reassignment NPD
• Wayne E Tasker

  • Clinical Social Worker
  • Morristown, TN
  • NPI 1235273673
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891876819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4018",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376024018",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 E STONEBROOK PL",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604000",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Park Blvd Ste 350W",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207471",
            "country_code": "US",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.A., PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "2783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Michael Smith, PHARMD
• Michelle Smith, FNP
• Nancy Smith, NP-C
• Phinetta Kay Smith, BS
• Ronald Steven Smith, MD
• Sybil Rebekah Smith, M.A., LPC-MHSP
• Tasha Renee Smith, CCC-SLP
• Tiffany Smith, BCBA
• Wanda W Smith
• Sarah Smithson

• Clinical Psychologist in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.