TRISTAN ANTHONY SMYTH DO
NPI 1316634439
Student in an Organized Health Care Education/Training Program in Fayetteville, NC

Q: What is Tristan Smyth's NPI number?

The NPI number for Tristan Smyth is 1316634439. It was assigned to this individual provider in the NPPES registry on April 19, 2023.

Q: What is Tristan Smyth's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Tristan Smyth was last updated on April 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 April 19, 2023PECOS Enrolled

1638 OWEN DR, FAYETTEVILLE, NC 28304(910) 615-4000 Get Directions Write a Review

NPPES record last updated: April 19, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Tristan Anthony Smyth Do NPPES

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

TRISTAN ANTHONY SMYTH DO (NPI 1316634439) is an individual student in an organized health care education/training program in Fayetteville, North Carolina and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316634439

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameTRISTAN ANTHONY SMYTHCredential: DO

Location Address1638 OWEN DRFayetteville, NC 28304-3424

Mailing Address1638 Owen DrFayetteville, NC 28304-3424 · (910) 615-4000

Phone(910) 615-4000

Sole ProprietorNo

Enumeration DateApril 19, 2023

NPPES CertifiedApril 19, 2023

✔ NPI 1316634439 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1638 OWEN DR, Fayetteville, NC 28304

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tristan Anthony Smyth Do 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 20

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

HEATHER MCPHAIL COAXUM NP

Nurse Practitioner (Family)