DR MARK SMITH PA
NPI 1497008411
Clinic/Center in Fort Worth, TX

NPI Status: Active since October 16, 2012

Contact Information

7100 OAKMONT BLVD. # 108
FORT WORTH, TX
ZIP 76132
Phone: (817) 370-2657
Fax: (817) 370-2186

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  • Organization
  • Clinic/Center
  • CLIA Number: 45D0703264
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-31-2026

About DR MARK SMITH PA

This page provides the complete NPI Profile along with additional information for Dr Mark Smith Pa, a provider established in Fort Worth, Texas operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1497008411 assigned on October 2012. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Mrs. Daphne Anglin (Office Manager)

NPI
1497008411
Provider Name
DR MARK SMITH PA
Entity Type
Organization
Location Address
7100 OAKMONT BLVD. # 108 FORT WORTH, TX 76132
Location Phone
(817) 370-2657
Location Fax
(817) 370-2186
Mailing Address
7100 OAKMONT BLVD. # 108 FORT WORTH, TX 76132
Mailing Phone
(817) 370-2657
Mailing Fax
(817) 370-2186
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-16-2012
Last Update Date
10-16-2012
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center

Taxonomy Code
261Q00000X
Type
Ambulatory Health Care Facilities
Taxonomy Description
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. DAPHNE ANGLIN

Authorized Official Title
OFFICE MANAGER
Authorized Official Phone
(817) 370-2657

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
E61721MEDICARE UPIN (02)TX 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D0703264
Facility Type
Physician Office
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
MARK D. SMITH
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Dr Mark Smith Pa in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1497008411, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
7
Unchanged
Pos 5
0
Doubled → 0
Pos 6
0
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
4
Unchanged
Pos 9
1
Doubled → 2
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 0 → 0 8 → 16 → 7 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 8 + 7 + 0 + 0 + 1 + 6 + 4 + 2 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1497008411.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1497008411, enumerated as an "organization" on October 16, 2012.

The provider is located at 7100 OAKMONT BLVD. # 108 FORT WORTH, TX 76132 and the phone number is (817) 370-2657.

Clinic/Center with taxonomy code 261Q00000X.

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