THEODORE RAVENEL SMITH


Address: 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075
Phone: 8642538170

THEODORE RAVENEL SMITH (NPI# 1275587982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275587982
Entity Type Individual
Full Name THEODORE RAVENEL SMITH
Credential MD
Practice Address 1690 Skylyn Dr Ste 210
Spartanburg
SC 29307-1075
Mailing Address Po Box 743070
Atlanta
GA 30374-3070
Practice Telephone 8642538170
Practice Fax Number 8645857787
Mailing Telephone 8645604304
Mailing Fax Number 8645604413
Enumeration Date 2006-05-19
Last Update Date 2020-11-05
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 7493 SC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
GA MEDICARE RAILROAD PTAN# P00386787 01
SC MEDICARE PIN SCE4946084 01
SC 074939 05
SC MEDICARE PIN SCE4946067 01
SC MEDICARE PIN SCE494J577 01

Other Providers THEODORE SMITH

NPI Name Taxonomy Address Enumeration
1053932111 Theodore L Smith Peer Specialist 9401 Lorain Ave # 102, Cleveland, OH 44102-4726 2020-04-29
1144790627 Theodore Roosevelt Smith Licensed Practical Nurse 830 Ezzard Charles Drive, Cincinnati, OH 45214 2018-11-28
1427203157 Theodore Vandix Smith IIi Counselor 71-50 Parsons Blvd., Flushing, NY 11365 2008-11-21
1629228408 Theodore Michael Smith Massage Therapist 13818 6760 Rd, Montrose, CO 81401-7494 2008-09-29
1558583492 Theodore Williams Smith Psychiatry & Neurology 100 Edgewood Avenue N.e., Suite 1228, Atlanta, GA 30303-3068 2007-05-02
1265544340 Theodore G. Smith Chiropractor 639 Old Phoenix Rd, Eatonton, GA 31024-5610 2006-08-31
1477152924 Theodore Smith Social Worker 140 Michigan Ave W, Battle Creek, MI 49017-3602 2020-10-25
1649880758 Theodore James Smith Physical Therapist 4605 Sawmill Rd, Upper Arlington, OH 43220-2246 2020-08-04
1336506658 Theodore C Smith Registered Nurse 600 East Blvd, Elkhart, IN 46514-2483 2016-01-16
1841600947 Theodore Roosevelt Smith IIi Behavioral Analyst 3171 S Jones Blvd, Las Vegas, NV 89146-6703 2014-04-29

Office Location

Street Address 1690 SKYLYN DR STE 210
City SPARTANBURG
State SC
Zip Code 29307-1075

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700842333 Matthew Jonathan Edwards Family Medicine 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075 2006-04-22
1174092449 Spartanburg Medical Center Family Medicine 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075 2018-11-16
1275057770 Brittany Earnhardt Saleeby Nurse Practitioner 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307 2017-07-27
1760493985 Mary Black Hlth Sys, LLC Durable Medical Equipment & Medical Supplies 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075 2006-08-11
1457366262 Donna-marie Koroma Family Medicine 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075 2006-07-30
1477506673 Henry G. Cupstid Family Medicine 1690 Skylyn Dr Ste 210, Spartanburg, SC 29307-1075 2006-05-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023677945 Healogics Specialty Physicians of South Carolina, LLC Clinic/Center 1630 Skylyn Drive, Suite 420, Spartanburg, SC 29307 2019-06-13
1194247528 Tawnia Lee Prince Occupational Therapy Assistant 110 Summit Knoll Drive, Spartanburg, SC 29307 2017-07-07
1730633553 Laura K Taylor Chiropractor 1802 Drayton Road, Suite 309, Spartanburg, SC 29307 2016-08-10
1013372390 Erin Lavette Farr Nurse Practitioner 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 2015-12-30
1316312010 Joy Rogers Speech-Language Pathologist 175 Burdette St, Spartanburg, SC 29307 2015-12-07
1376923169 Olivia Conrad Speech-Language Pathologist 220 Sloans Grove Rd, Spartanburg, SC 29307 2015-06-05
1457755118 Optimal Radiology Partners of Virginia, Pllc Radiology 75 Skylyn Drive, Spartanburg, SC 29307 2014-10-09
1295033272 Sean Quinn Pharmacist 790 East Main Street, Spartanburg, SC 29307 2011-03-01
1417250887 James Edward Bradof Internal Medicine 212 Cypress Creek Drive, Spartanburg, SC 29307 2010-12-07
1528388030 Tanya Tocharoen Tang Internal Medicine 126 Dillon Dr., Spartanburg, SC 29307 2010-06-07
Find all providers in zip 29307

Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1033716253 Proactive Md Tindall Spartanburg Health Center Family Medicine 2273 Hayne St., Spartanburg, SC 29301 2020-10-01
1013532126 Adam Joseph Fulcher Family Medicine Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 2020-06-15
1538713813 Proactive Md Sc,p.a. Family Medicine 101 W Saint John St Ste 107, Spartanburg, SC 29306-5157 2019-07-25
1073171336 Proactive Md Sc,p.a. Family Medicine 801 Union St, Spartanburg, SC 29302-2734 2019-06-03
1841757192 Paladina Health, LLC Family Medicine Paladina Health Smith Drug, 9098 Fairforest Road, Spartanburg, SC 29301 2019-02-22
1487111738 Paladina Health, LLC Family Medicine Paladina Health Spartanburg Palmetto Bank, 101 West Saint John Street Suite 107, Spartanburg, SC 29306 2019-02-22
1649735127 Spartanburg Medical Center Family Medicine 11 Doctors Park Dr Ste 200, Spartanburg, SC 29307-1008 2019-02-08
1114403342 Piedmont Care, Inc. Family Medicine 101 N Pine St Ste 200, Spartanburg, SC 29302-1604 2018-07-11
1356871933 Kristy Kaye Atkinson Family Medicine 853 N Church St # 150, Spartanburg, SC 29303-3098 2017-06-15
1003352261 Academic Primary Care Associates Family Medicine 410 Magnolia St, Spartanburg, SC 29303-3640 2017-01-12
Find all providers in SPARTANBURG

Competitor

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City SPARTANBURG
Zip Code 29307

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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