NPIMap

Organization Active NPI

Floyd D Smith, MD, Internal Medicine, PS

  • Medical Specialty Clinic/Center
  • Centralia, WA
National Provider Identifier
1932597077
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
MD00019740 Issued in WA
Legal business name
FLOYD D SMITH, MD, INTERNAL MEDICINE, PS
Practice address
1611 Kresky Ave
Suite 112
Centralia, WA 98531-8982
Phone
(360) 330-2023
Fax
(360) 623-1585
NPI assigned
Dec 23, 2014
Organization subpart
Yes
Parent organization
FLOYD D. SMITH, MD, INTERNAL MEDICINE, PSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Dr. Floyd D. Smith, MDNPI 1437218211
Title
President
Phone
(360) 330-2023

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X MD00019740 WA Primary

Addresses

Primary practice location

1611 Kresky Ave
Suite 112
Centralia, WA 98531-8982

Mailing address

PO Box 868
Centralia, WA 98531-0868
Phone (360) 330-2023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150702000354 WA Part B Supplier - Clinic/Group Practice 3678885779 Receives reassigned benefits from 1 practitioner
Practice locations: Centralia, WA

National Provider Directory

National Provider Directory
Part of
Floyd D Smith MD Internal Medicine PS

Locations

1611 Kresky Ave
Ste 112
Centralia, WA 98531
Phone (360) 330-2023

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FGDCCA

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1932597077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 868",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985310868",
            "telephone_number": "360-330-2023",
            "fax_number": "360-623-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 KRESKY AVE",
            "address_2": "SUITE 112",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318982",
            "telephone_number": "360-330-2023",
            "fax_number": "360-623-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOYD D SMITH, MD, INTERNAL MEDICINE, PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLOYD D. SMITH, MD, INTERNAL MEDICINE, PS",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "FLOYD",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-330-2023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "MD00019740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.