NPIMap

Individual provider Active NPI

Allistair McDonald Smith, PA

  • Physician Assistant
  • Davenport, FL
National Provider Identifier
1932682432
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111535 Issued in FL
Practice address
40100 US-27
Davenport, FL 33837
Phone
(863) 422-4971
NPI assigned
Sep 11, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111535 FL Primary

Addresses

Primary practice location

40100 US-27
Davenport, FL 33837

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190117003304 FL Practitioner - Physician Assistant 9638415268 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgewood Emergency Group, LLC Physician Assistant CurrentSince Dec 31, 2018 Accepting new patients
Advance Practice Practitioner LLC Physician Assistant PastSince Dec 17, 2023 Accepting new patients

Locations

40100 Highway 27
Davenport, FL 33837
Phone (863) 419-2496

200 Corporate Blvd
Lafayette, LA 70508

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1932682432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40100 US-27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33837",
            "telephone_number": "863-422-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALLISTAIR",
        "middle_name": "MCDONALD",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.