DR. SHANE R SMITH (NPI# 1538134572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538134572 |
| Entity Type | Individual |
| Full Name | DR. SHANE R SMITH |
| Credential | MD |
| Practice Address |
621 E Matthews Ave Jonesboro AR 72401-3145 |
| Practice Telephone | 8709326799 |
| Practice Fax Number | 8709328423 |
| Mailing Telephone | 8709326799 |
| Mailing Fax Number | 8709328423 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
E3427 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BCBS OF AR | 5M220 | 01 |
| AR | 146939001 | 05 | |
| AR | RAILROAD MEDICARE | P00062106 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801363288 | Shane Smith | Counselor | 10401 Shaw St, Oakland, CA 94605-5116 | 2018-10-24 |
| 1609306158 | Shane Eric Smith | Chiropractor | 1300 E 66th St Ste 100, Richfield, MN 55423-2685 | 2017-06-18 |
| 1396199733 | Shane Todd Smith | Registered Nurse | 725 Rothrock Dr, Galloway, OH 43119-8692 | 2016-04-22 |
| 1679815484 | Shane Timothy Smith | Counselor | 4629 Celia Way, Apt 202, Bellingham, WA 98226-7475 | 2013-03-19 |
| 1972726719 | Shane Smith | Chiropractor | 1380 Long Fellow Ave, Chico, CA 95926 | 2007-04-10 |
| 1821177197 | Shane Smith | Chiropractor | 2301 Berlin Tpke, Newington, CT 06111-3206 | 2006-11-06 |
| 1184705980 | Shane Michael Smith | Family Medicine | 516 W 14th Ave Ste 100, Holdrege, NE 68949-1215 | 2006-10-18 |
| 1003465675 | Shane R Smith | Social Worker | 403 Stony Landing Rd, Moncks Corner, SC 29461-3967 | 2019-09-06 |
| 1255859567 | Shane Mcbride Smith | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2017-09-07 |
| 1124578836 | Shane Smith | Chiropractor | 12313 Gold St, Omaha, NE 68144-2760 | 2016-10-05 |
| Street Address |
621 E MATTHEWS AVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-3145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851366140 | Joseph H Sales | Otolaryngology | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2006-02-21 |
| 1497241343 | Katie N Blalack | Nurse Practitioner | 621 E Matthews Ave, Jonesboro, AR 72401 | 2018-07-03 |
| 1114447000 | Hayley Himstedt | Audiologist | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2017-06-22 |
| 1508395427 | Sarah Holland Benton | Audiologist | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2017-06-05 |
| 1922425818 | Otolaryngology and Facial Surgery Center of Northeast Ark Pa | Audiologist-Hearing Aid Fitter | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2014-03-28 |
| 1013359769 | Heather Stallings | Nurse Practitioner | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2013-07-23 |
| 1497062509 | Mary C Criner | Audiologist | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2010-09-10 |
| 1659340297 | Ne Arkansas Otolaryngology Facial Surgery P A | Otolaryngology | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2006-03-16 |
| 1871568808 | John B Jiu | Otolaryngology | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2006-02-22 |
| 1588639512 | David Lewis | Otolaryngology | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2006-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326013269 | Gary W Woodward | Otolaryngology | 621 E Matthews, Jonesboro, AR 72401-3145 | 2006-02-22 |
| 1851366140 | Joseph H Sales | Otolaryngology | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2006-02-21 |
| 1659340297 | Ne Arkansas Otolaryngology Facial Surgery P A | Otolaryngology | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2006-03-16 |
| 1871568808 | John B Jiu | Otolaryngology | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2006-02-22 |
| 1588639512 | David Lewis | Otolaryngology | 621 E Matthews Ave, Jonesboro, AR 72401-3145 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306814116 | Russellville Ear Nose and Throat Surgery Clinic, P.a. | Otolaryngology | 106 S Inglewood Ave, Russellville, AR 72801-3353 | 2006-03-08 |
| 1912973306 | Ezechiel R. Nehus | Otolaryngology | 200 N Quanah Ave, Russellville, AR 72801-2762 | 2006-02-24 |
| 1639460777 | Philip Kurt Robb Jr. | Otolaryngology | 4301 W Markham St, 543, Little Rock, AR 72205-7101 | 2011-04-24 |
| 1467629469 | Ccent & Fps | Otolaryngology | 300 W White Mountain Blvd, Suite D, Lakeside, AR 85929-6533 | 2008-05-09 |
| 1174613665 | Emre Vural | Otolaryngology | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2006-10-13 |
| 1730157256 | Nathan F. Austin | Otolaryngology | 106 S Inglewood Ave, Russellville, AR 72801-3353 | 2006-03-10 |
| 1013985969 | Stephen M. Killingsworth | Otolaryngology | 200 N Quanah Ave, Russellville, AR 72801-2762 | 2006-03-08 |
| 1760459952 | Stephen M. Killingsworth, Md, Pa | Otolaryngology | 200 N Quanah Ave, Russellville, AR 72801-2762 | 2006-03-07 |
| 1871569269 | Ezechiel R. Nehus, Md, Pa | Otolaryngology | 200 N Quanah Ave, Russellville, AR 72801-2762 | 2006-02-24 |
| 1386638286 | William Jennison Bulkley | Otolaryngology | 1000 W Kingshighway, Ste 3, Paragould, AR 72450-4141 | 2005-09-07 |
| Find all providers with the same taxonomy | ||||
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| 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.