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

Active since October 06, 2006PECOS Enrolled
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: July 19, 2026.

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 is enrolled in Medicare PECOS.

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
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

Other Identifiers 1

Other4043727TN · Blue Cross/ Blue Shield

Medicare Participation & PECOS Enrollment Status

Coleen Smith is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 04-01-2013

  • Opt-Out End Date: 04-01-2027

  • Eligible to Order and Refer? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Acupuncturist
111 W 10TH AVE
JOHNSON CITY, TN 37604

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164519880, enumerated as an "individual" on October 06, 2006.

The provider is located at 111 W 10TH AVE JOHNSON CITY, TN 37604 and the phone number is (423) 722-9355.

Neuromusculoskeletal Medicine & OMM with taxonomy code 204D00000X.

The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.