Mary Beth Smith, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

LL32829 Issued in SC

Practice address

603 Wheat Ave Ste 450
Bainbridge, GA 39819-4365

Phone

(229) 246-1209

Fax

(229) 243-7707

NPI assigned

Jun 18, 2010

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marybeth.smith@mh-m.gadirect.net

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.

• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1922329481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 WHEAT AVE STE 450",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194365",
            "telephone_number": "229-246-1209",
            "fax_number": "229-243-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 WHEAT AVE STE 450",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194365",
            "telephone_number": "229-246-1209",
            "fax_number": "229-243-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL32829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136009A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "070431",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serendipity Counseling & Consulting Agency
• Tabitha G Sharber, PT, DPT
• Ashlie Avery Shipes, LCSW
• Amy Shiver
• Latoya Simmons
• Richard Lynn Smith, R. PH.
• Tracy Smith, NP-C
• South Albany Pharmacy
• South Albany Pharmacy LLC
• South Georgia Spine and Joint Center, LLC

• All providers in Bainbridge, GA
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.