SMH Professional Serv at SMH

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

SMH PROFESSIONAL SERV AT SMH

Practice address

1001 Gause Blvd
Slidell, LA 70458-2939

Phone

(985) 643-2200

NPI assigned

May 30, 2005

Organization subpart

No

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

Authorized official

Name

Bill Davis

Title

Cfo

Phone

(985) 649-8866

Specialties & licenses 2

Addresses

Other identifiers 2

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Slidell Memorial Hospital

  • General Acute Care Hospital
  • Slidell, LA
  • NPI 1578568481

  Member Of

  NPD member

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

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253491200000",
    "number": "1942203476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 INNWOOD DR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704339123",
            "telephone_number": "985-892-3225",
            "fax_number": "985-234-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 GAUSE BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582939",
            "telephone_number": "985-643-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMH PROFESSIONAL SERV AT SMH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-30",
        "last_updated": "2009-09-21",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "985-649-8866"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1442755",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016024",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Slidell Pharmacy LLC
• Slidell Specialty Hospital LP
• P. Douglas Slocum, M.D.
• Mirtza Martinez Small, FNP-C
• Shcandtel Smallwood
• Eshantti Kayafai Smith-Trask, MSW,RSW
• Alicia Nicole Smith, DC
• Andra Gloria Smith, MS CTRS
• Ashley Elizabeth Smith, HS
• Baylie Smith

• Pain Medicine (Anesthesiology) Physician in Slidell, LA
• Providers in Slidell, LA by specialty
• Pain Medicine (Anesthesiology) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.