Annie Michele Smith, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017107 Issued in IL

Practice address

1770 E Lake Shore Dr
#209
Decatur, IL 62521-3832

Phone

(217) 423-6500

NPI assigned

Dec 13, 2016

Last updated

Dec 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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 IL

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 Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Decatur Psychiatry LTDGroup PAC ID 8426065186, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Decatur Psychiatry LTD

  • Psychiatry Physician
  • Decatur, IL
  • NPI 1770638686
  Medicare reassignment Care Compare group
• John Herington, PC

  dba John Herington LCSW

  • Clinical Social Worker
  • Decatur, IL
  • NPI 1598869588
  NPD (past)
• Rohidas T Patil MD SC

  • Psychiatry Physician
  • Decatur, IL
  • NPI 1316110893
  NPD (past)

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1902340730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 E. LAKE SHORE DR.",
            "address_2": "#209",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625223832",
            "telephone_number": "217-423-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR",
            "address_2": "#209",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213832",
            "telephone_number": "217-423-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANNIE",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Smith
• Addie L Smith, LSW
• Amy Smith, M.S.
• Amy Ann Smith, PA-C
• Andrea Lynne Smith, LSW
• Daniel Burtion Smith, M.D.
• Elizabeth K Smith, LPN
• Eric Smith, HIS
• Faith R Smith
• Jeffery M Smith, M.D.

• Clinical Social Worker in Decatur, IL
• Providers in Decatur, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.