Individual provider Active NPI

Matthew Clinton Smith, D.C.

  • Chiropractor
  • Mount Juliet, TN
National Provider Identifier
1962809640
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2827 Issued in TN
Practice address
730 N Mount Juliet Rd
Mount Juliet, TN 37122-3950
Phone
(615) 804-0458
NPI assigned
Nov 25, 2014
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2827 TN Primary

Addresses

Primary practice location

730 N Mount Juliet Rd
Mount Juliet, TN 37122-3950

Mailing address

429 S Rutland Rd
Mount Juliet, TN 37122-4901
Phone (615) 804-0458

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150321000227 TN Practitioner - Chiropractic 4183949860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smith Chiropractic and RehabilitationGroup PAC ID 3274858956, 2 clinicians

Practice addresses (Care Compare)

730 N Mount Juliet Rd
Mt Juliet, TN 37122-3950
Phone (615) 758-8560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Smith Chiropractic & Rehabilitation Chiropractor CurrentSince Dec 2, 2014 Accepting new patients

Locations

1400 N Mount Juliet Rd
Ste 104
Mt Juliet, TN 37122
Phone (615) 804-0458

730 N Mount Juliet Rd
Mt Juliet, TN 37122
Phone (615) 758-8560

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1962809640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 S RUTLAND RD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371224901",
            "telephone_number": "615-804-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N MOUNT JULIET RD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223950",
            "telephone_number": "615-804-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTHEW",
        "middle_name": "CLINTON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-25",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.