NPIMap

Organization Active NPI

Paul Grayson Smith, Jr., D.O., P.C.

  • Family Medicine Physician
  • Cleveland, TN
National Provider Identifier
1952472185
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO256 Issued in TN
Legal business name
PAUL GRAYSON SMITH, JR., D.O., P.C.
Practice address
2121 N Ocoee St
Suite 101
Cleveland, TN 37311-3953
Phone
(423) 472-6548
Fax
(423) 472-8318
NPI assigned
Nov 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Angela Dawn Digiammarino
Title
Practice Manager
Phone
(423) 472-6548

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO256 TN Primary

Addresses

Primary practice location

2121 N Ocoee St
Suite 101
Cleveland, TN 37311-3953

Mailing address

2121 N Ocoee St
Suite 101
Cleveland, TN 37311-3953
Phone (423) 472-6548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051114001051 TN Part B Supplier - Clinic/Group Practice 5294754792 Receives reassigned benefits from 9 practitioners
Practice locations: Cleveland, TN

National Provider Directory

National Provider Directory

Locations

2121 N Ocoee St
Cleveland, TN 37311

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952472185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 N OCOEE ST",
            "address_2": "SUITE 101",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113953",
            "telephone_number": "423-472-6548",
            "fax_number": "423-472-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N OCOEE ST",
            "address_2": "SUITE 101",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113953",
            "telephone_number": "423-472-6548",
            "fax_number": "423-472-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL GRAYSON SMITH, JR., D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIGIAMMARINO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "423-472-6548",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.