CYNTHIA M SMITH PA-C
NPI 1033179700
Physician Assistant - Medical in Fayetteville, GA

Q: What is Cynthia Smith's NPI number?

The NPI number for Cynthia Smith is 1033179700. It was assigned to this individual provider in the NPPES registry on March 25, 2006. The provider is also known as Cynthia M Theobald Pa-C.

Q: What is Cynthia Smith's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Cynthia Smith was last updated on June 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 25, 2006PECOS Enrolled

1275 HIGHWAY 54 W STE 201, FAYETTEVILLE, GA 30214(770) 461-3776(770) 461-3565 Get Directions Write a Review

NPPES record last updated: June 29, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 5, 2019, May 18, 2018 (2 updates tracked since 2018).

On this page

About Cynthia M Smith Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CYNTHIA M SMITH PA-C (NPI 1033179700) is an individual medical provider in Fayetteville, Georgia, licensed in Georgia (7814) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Maxwell Afb.

NPPES Registry Identity

NPI1033179700

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameCYNTHIA M SMITHCredential: PA-C

Location Address1275 HIGHWAY 54 W STE 201Fayetteville, GA 30214-4538

Mailing Address3330 Cobb Pkwy Nw Ste 324-201Acworth, GA 30101-8320 · (915) 474-7675

Phone(770) 461-3776

Fax(770) 461-3565

Sole ProprietorNo

Enumeration DateMarch 25, 2006

Last NPPES UpdateJune 29, 20222 updates tracked since enumeration

NPPES CertifiedJune 29, 2022

✔ NPI 1033179700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in GA · 7814

Also ListedPhysician AssistantTaxonomy 363A00000X · License 50-002328 (OH)

1275 HIGHWAY 54 W STE 201, Fayetteville, GA 30214

Open in Google Maps ↗

Other Names 1

Former Name (1)Cynthia M Theobald Pa-c

Secondary Practice Location 1

Location 142d Medical Group, 300 Twining St., Bldg 760Maxwell AFB, AL 36112 · Phone (334) 953-3368 · Fax (334) 953-8607

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cynthia M Smith Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA KATHERINE VERNON PA-C

Physician Assistant (Medical)