Carolyn Shannon Smith, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

38125 Issued in WI

Practice address

545 N 15TH St
Milwaukee, WI 53233-2237

Phone

(414) 288-7184

NPI assigned

Dec 6, 2006

Last updated

Jul 8, 2007By 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 WI

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

Specialty

Family Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Milwaukee Orthopaedic Group LTDGroup PAC ID 2769466036, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Milwaukee Orthopaedic Group LTD

  • Specialist
  • Milwaukee, WI
  • NPI 1013071349
  Medicare reassignment Care Compare group NPD
• Milwaukee Orthopaedic Group LTD

  • Specialist
  • Mequon, WI
  • NPI 1043373178
  NPD (past)
• Milwaukee Orthpaedic Group LTD

  • Specialist
  • Milwaukee, WI
  • NPI 1447284799
  NPD (past)
• Student Health Service

  • Student Health Clinic/Center
  • Milwaukee, WI
  • NPI 1932236726
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902965965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W INDIAN CREEK CT",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532172323",
            "telephone_number": "414-540-6593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N 15TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332237",
            "telephone_number": "414-288-7184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAROLYN",
        "middle_name": "SHANNON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "38125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bente E Smith, PA-C
• Bernard Smith, M.D.
• Bradley Smith, FNP-BC
• Brianna Smith, CBRF CERTIFIED
• Candice Smith
• Charlene Smith, LPC
• Charlene Smith
• Chloey Ann Smith
• Christine Smith
• Coleen Haas Smith, MAPC

• Sports Medicine (Family Medicine) Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Sports Medicine (Family Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.