NPIMap

Individual provider Active NPI

Chad J. Smith, D.O.

  • Family Medicine Physician
  • Warrenton, MO
National Provider Identifier
1982600615
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2003015262 Issued in MO
Practice address
18800 Schnucks Dr Ste B
Warrenton, MO 63383-1121
Phone
(636) 456-3413
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2003015262 MO Primary

Addresses

Primary practice location

18800 Schnucks Dr Ste B
Warrenton, MO 63383-1121

Mailing address

PO Box 955534
Saint Louis, MO 63195-0001

Other practice location 1

605 E Booneslick Rd
Ste B
Warrenton, MO 63383-2101
Phone (636) 456-3413

Other practice location 2

722 N State Highway 47
Warrenton, MO 63383-1108
Phone (636) 456-3413

Other identifiers 1

IdentifierTypeStateIssuer
209231604MedicaidMO

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address csmith5843@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040824000261 MO Practitioner - Family Practice 1052385267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

722 N State Hwy 47 B
SSM Health Medical Group
Warrenton, MO 63383-1108
Phone (636) 456-3413

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2003015262MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients
SSM Health Care St. Louis PastSince Jun 16, 2024 Accepting new patients

Locations

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

722 N State Highway 47
#B
Warrenton, MO 63383
Phone (636) 456-3413

18800 Schnucks Dr
Ste B
Warrenton, MO 63383
Phone (636) 456-3413

18800 Schnucks Dr
Warrenton, MO 63383
Phone (636) 456-3413

Organizations & group practices 2

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1982600615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 955534",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18800 SCHNUCKS DR STE B",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633831121",
            "telephone_number": "636-456-3413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 E Booneslick Rd",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "MO",
            "postal_code": "633832101",
            "country_code": "US",
            "telephone_number": "636-456-3413",
            "fax_number": "636-456-7238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "722 N State Highway 47",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "MO",
            "postal_code": "633831108",
            "country_code": "US",
            "telephone_number": "636-456-3413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHAD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2003015262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209231604",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csmith5843@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "csmith5843@direct-ehr-ssmhc.com",
            "address_1": "18800 Schnucks Dr Ste B",
            "city": "Warrenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633831121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "18800 Schnucks Dr Ste B",
            "city": "Warrenton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633831121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warrenton, MO

Sources for this page

Verify at the official NPI Registry.