COLEEN MARIE SMITH D.O.
NPI 1164519880
Neuromusculoskeletal Medicine & OMM in Johnson City, TN

Q: What is Coleen Smith's NPI number?

The NPI number for Coleen Smith is 1164519880. It was assigned to this individual provider in the NPPES registry on October 6, 2006.

Q: What is Coleen Smith's specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine & OMM with taxonomy code 204D00000X.

Q: Is Coleen Smith enrolled in Medicare?

No. Coleen Smith has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Coleen Smith was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since October 06, 2006Opted out of Medicare · through Apr 1, 2027

111 W 10TH AVE, JOHNSON CITY, TN 37604(423) 722-9355(423) 722-9333 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Coleen Marie Smith D.o. NPPES

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

COLEEN MARIE SMITH D.O. (NPI 1164519880) is an individual neuromusculoskeletal medicine & omm provider in Johnson City, Tennessee, licensed in Tennessee (1434) and active in the NPI registry since October 2006. She has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1164519880

Entity TypeIndividualFemale

Primary Taxonomy204D00000X

Provider Legal NameCOLEEN MARIE SMITHCredential: D.O.

Location Address111 W 10TH AVEJohnson City, TN 37604-3844

Mailing Address111 W 10th AveJohnson City, TN 37604-3844 · (423) 722-9355 · Fax (423) 722-9333

Phone(423) 722-9355

Fax(423) 722-9333

Sole ProprietorYes

Enumeration DateOctober 6, 2006

Last NPPES UpdateSeptember 11, 2025

✔ NPI 1164519880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNeuromusculoskeletal Medicine & OMMAllopathic & Osteopathic Physicians

Taxonomy Code204D00000X

License✔ Licensed in TN · 1434

Definition

The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 1434 (TN)

111 W 10TH AVE, Johnson City, TN 37604

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Other Identifiers 1

Other4043727TN · Blue Cross/ Blue Shield

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Coleen Marie Smith D.o. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2013 through April 1, 2027.

Opt-Out Effective DateApril 1, 2013

Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES

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

MICHELLE BOUTON L.AC., M.A.O.M.

Acupuncturist

111 W 10TH AVE
JOHNSON CITY, TN 37604

Washington County (423) 612-7494

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 Coleen Smith's NPI number?

The NPI number for Coleen Smith is 1164519880. It was assigned to this individual provider in the NPPES registry on October 6, 2006.

Where is Coleen Smith located?

Coleen Smith practices at 111 W 10th Ave, Johnson City, TN 37604. The listed phone number is (423) 722-9355.

What is Coleen Smith's specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine & OMM with taxonomy code 204D00000X.

Is Coleen Smith enrolled in Medicare?

No. Coleen Smith has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Coleen Smith was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.