Individual provider Active NPI

Lonnie Ray Smith, M.D.

  • Otolaryngology Physician
  • Tulare, CA
National Provider Identifier
1992817936
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G516370 Issued in CA
Practice address
1066 N Cherry St
Tulare, CA 93274-2251
Phone
(559) 686-2599
Fax
(559) 686-5206
NPI assigned
Aug 31, 2006
Last updated
Jan 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G516370 CA Primary

Addresses

Primary practice location

1066 N Cherry St
Tulare, CA 93274-2251

Mailing address

470 E Chevy Chase Dr
Tulare, CA 93274-1509
Phone (559) 688-7614

Other identifiers 2

IdentifierTypeStateIssuer
00G516371MedicaidCA
1730494634OtherCANPI-TYPE 2

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100824000298 CA Practitioner - Otolaryngology 4284716762 Reassigns benefits to 4 organizations
I20241112003935 MT Practitioner - OtolaryngologyPractitioner - Sleep Medicine 4284716762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Altura Centers for HealthGroup PAC ID 9830103449, shared by 7 NPIs, 26 clinicians
Rocky Mountain Sleep Disorders Center IncGroup PAC ID 6709784606, 4 clinicians

Practice addresses (Care Compare)

1066 N Cherry St
Tulare, CA 93274-2251
Phone (559) 686-2599

1101 N Cherry St
Tulare, CA 93274-2231
Phone (559) 686-9097

1917 4TH St S
Suite 101
Great Falls, MT 59405-4116
Phone (406) 453-7570

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G516370CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altura Centers for Health Otolaryngology Current Accepting new patients
Department of State Hospitals CurrentSince Jan 8, 2013 Accepting new patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Jan 8, 2013 Accepting new patients
Aristamd CurrentSince Apr 1, 2021 Accepting new patients
Altura Centers for Health Otolaryngology CurrentSince Nov 1, 2019 Accepting new patients
Altura Centers for Health Otolaryngology CurrentSince Nov 1, 2019 Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients
Adventist Health Tulare PastSince Aug 18, 2009 Accepting new patients

Locations

3102 E Highland Ave
Patton, CA 92369
Phone (909) 425-7000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

4755 Nexus Center Dr
San Diego, CA 92121
Phone (858) 750-4777

1101 N Cherry St
Tulare, CA 93274
Phone (559) 686-9097

1134 E Cartmill Ave
Tulare, CA 93274
Phone (559) 686-9097

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a36dfa71-4dd3-4608-9cfb-c7a63ade5531/
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: lonnie.smith.p1@direct.altura.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Medical Center-CopperopolisCopperopolis, CA, CCN 058548 Rural health clinic W-2 Managing Employee Oct 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1992817936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 E CHEVY CHASE DR",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932741509",
            "telephone_number": "559-688-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 N CHERRY ST",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932742251",
            "telephone_number": "559-686-2599",
            "fax_number": "559-686-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LONNIE",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G516370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G516371",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-TYPE 2",
            "identifier": "1730494634",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulare, CA

Sources for this page

Verify at the official NPI Registry.