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ETHEL L SMITH MD
NPI 1104817014
Family Medicine in Conyers, GA

Active since October 31, 2005PECOS Enrolled
2020 HONEY CREEK PKWY SE, CONYERS, GA 30013(770) 919-0813(770) 929-3868 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ethel L Smith Md NPPES

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

ETHEL L SMITH MD (NPI 1104817014) is an individual family medicine provider in Conyers, Georgia, licensed in Georgia (31510) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104817014
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameETHEL L SMITHCredential: MD
Location Address2020 HONEY CREEK PKWY SEConyers, GA 30013
Mailing Address2020 Honey Creek Pkwy SeConyers, GA 30013 · (770) 919-0813 · Fax (770) 929-3868
Phone(770) 919-0813
Fax(770) 929-3868
Sole ProprietorNo
Enumeration DateOctober 31, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1104817014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 31510
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.
2020 HONEY CREEK PKWY SE, Conyers, GA 30013
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethel L Smith Md 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Ethel Smith reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Theoria Medical
614 mi
Internal Medicine
41800 W 11 MILE RD STE 109
Novi, MI 48375
  • Reassigned Medicare billing, Georgia enrollment
  • 110 clinicians in this Medicare group
NPI 1609362375 (248) 860-4634
Complexcare Medical Group Southeast H PLLC
614 mi
Internal Medicine
41800 W 11 MILE RD STE 109
Novi, MI 48375
  • Reassigned Medicare billing, Georgia enrollment
  • 29 clinicians in this Medicare group
NPI 1083508238 (248) 660-1220

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30013 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

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

GHULAM MUSTAFA JARWAR M.D
Pediatrics
2020 HONEY CREEK PKWY SE, SUITE E
CONYERS, GA 30013
Rockdale County (770) 922-0553
INDIRA R ASSER MD
Family Medicine
2020 HONEY CREEK PKWY SE
CONYERS, GA 30013
Rockdale County (770) 929-0813
NAYEEM AKMAL MD
Family Medicine
2020 HONEY CREEK PKWY SE
CONYERS, GA 30013
Rockdale County (770) 929-0813
MRS. KATIE LYN KURTZ PA-C
Physician Assistant (Medical)
2020 HONEY CREEK PKWY SE
CONYERS, GA 30013
Rockdale County (770) 929-0813
MARIA GOYCO M.D.
Internal Medicine
2020 HONEY CREEK PKWY SE
CONYERS, GA 30013
Rockdale County (770) 929-0813
MARY JANE B KASSAM MD
General Practice
2020 HONEY CREEK PKWY SE
CONYERS, GA 30013
Rockdale County (770) 929-0813
MARGARET ANNE GALBIERZ PA-C
Physician Assistant (Medical)
2020 HONEY CREEK PKWY SE
CONYERS, GA 30013
Rockdale County (770) 929-0813
MR. MICHAEL MARTIN JOHNSON PA-C
Physician Assistant (Medical)
2020 HONEY CREEK PKWY SE
CONYERS, GA 30013
Rockdale County (770) 929-0813

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethel Smith's NPI number?

The NPI number for Ethel Smith is 1104817014. It was assigned to this individual provider in the NPPES registry on October 31, 2005.

Where is Ethel Smith located?

Ethel Smith practices at 2020 Honey Creek Pkwy SE, Conyers, GA 30013. The listed phone number is (770) 919-0813.

What is Ethel Smith's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ethel Smith enrolled in Medicare?

Yes. Ethel Smith is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Ethel Smith's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethel Smith reassigns Medicare benefits to 2 organizations: Theoria Medical (Novi, MI) and Complexcare Medical Group Southeast H PLLC (Novi, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ethel Smith's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ethel Smith was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.