Active NPI
Adrian Smith Lineberger III, MD
- Anesthesiology Physician
- Grand Rapids, MI
National Provider Identifier
1992785067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301048530
- Practice address
- 3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493 - Phone
- (616) 364-4200
- Fax
- (616) 364-7347
- NPI assigned
- Jan 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4301048530 | MI | Primary |
| Anesthesiology Physician | 207L00000X | 26841 | NC |
Addresses
Primary practice location
3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Mailing address
344 Rolling Hill Rd
Ste 102
Mooresville, NC 28117-6865
Phone (616) 364-4200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3514393 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2017 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301048530 | MI | MD | Anesthesiology Physician |
| 26841 | NC | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Pain & Spine Care Specialists, LLC | Past | Accepting new patients | |
| DRS Farrell, Farrell, Nale, Cook, Kapitan, Mohamed, Franco, Wessel, Ho | Past | Accepting new patients | |
| DRS Farrell, Farrell, Nale, Cook, Kapitan, Mohamed, Franco, Wessel, Ho | Past | Accepting new patients | |
| Southeast Anesthesiology Consultants of Virginia, PLLC | Anesthesiology | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CDEHDD
Organizations & group practices 4
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.
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- Oral & Maxillofacial Surgery (D.M.D.)
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- NPI 1972554186
-
- Anesthesiology Physician
- Norfolk, VA
- NPI 1033242235
-
- Interventional Pain Medicine Physician
- Norfolk, VA
- NPI 1558179689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516924800000",
"number": "1992785067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "344 ROLLING HILL RD",
"address_2": "STE 102",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281176865",
"telephone_number": "616-364-4200",
"fax_number": "616-364-7347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259493",
"telephone_number": "616-364-4200",
"fax_number": "616-364-7347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINEBERGER",
"first_name": "ADRIAN",
"middle_name": "SMITH",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-17",
"last_updated": "2018-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301048530",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "26841",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3514393",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.