NATHAN SMITH MD
NPI 1376037697
Family Medicine in Newnan, GA

Q: What is Nathan Smith's NPI number?

The NPI number for Nathan Smith is 1376037697. It was assigned to this individual provider in the NPPES registry on June 20, 2018.

Q: What is Nathan Smith's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nathan Smith was last updated on April 15, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 20, 2018PECOS EnrolledAccepts Medicare Assignment

82.55/100

CMS Quality Rating

2401 NEWNAN CROSSING BLVD E STE 200, NEWNAN, GA 30265(770) 400-7700 Get Directions Write a Review

NPPES record last updated: April 15, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 15, 2024, Aug 27, 2021, Jun 20, 2018 (3 updates tracked since 2018).

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About Nathan Smith Md NPPES

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

NATHAN SMITH MD (NPI 1376037697) is an individual family medicine provider in Newnan, Georgia, licensed in Georgia (90043) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS, is affiliated with Piedmont Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1376037697

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameNATHAN SMITHCredential: MD

Location Address2401 NEWNAN CROSSING BLVD E STE 200Newnan, GA 30265-2409

Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420

Phone(770) 400-7700

Sole ProprietorNo

Medical School CMSRush Medical College Of Rush UniversityGraduated 2018

Enumeration DateJune 20, 2018

Last NPPES UpdateApril 15, 20243 updates tracked since enumeration

NPPES CertifiedApril 15, 2024

✔ NPI 1376037697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in GA · 90043✔ Licensed in IL · 125.073201

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.

2401 NEWNAN CROSSING BLVD E STE 200, Newnan, GA 30265

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Secondary Practice Locations 2

Location 195 Morrison Moore Pkwy W Ste 100Dahlonega, GA 30533-1588 · Phone (770) 219-9475 · Fax (706) 864-4484

Location 22020 Ogden Ave Ste 330Aurora, IL 60504-5897 · Phone (630) 978-4850 · Fax (630) 978-6865

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nathan Smith Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931456498

PECOS Enrollment IDI20210903000812

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.

Areas of Expertise CMS Part B claims 16

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

233 services176 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

216 services151 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

117 services99 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

69 services69 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

37 services34 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

29 services28 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

29 services29 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

29 services29 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

24 services24 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

23 services23 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

22 services22 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

21 services18 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

14 services14 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

14 services14 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

13 services13 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Piedmont Hospital

Acute Care Hospitals · Atlanta, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110083

Location1968 Peachtree Rd NWAtlanta, GA 30309 · Fulton County

Emergency services Birthing friendly

Piedmont Fayette Hospital

Acute Care Hospitals · Fayetteville, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110215

Location1255 Highway 54 WestFayetteville, GA 30214 · Fayette County

Emergency services Birthing friendly

Piedmont Newnan Hospital, Inc

Acute Care Hospitals · Newnan, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110229

Location745 Poplar RoadNewnan, GA 30265 · Coweta County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30265 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.55/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

81.14

Promoting Interoperability

100

Improvement Activities

Cost

60.7

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

1 supplier20 claims20 services$55.46 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

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

DR. ANDREW AUGUSTUS DUKE M.D.

Internal Medicine