DR. CHARLI WALTER LEROY SMITH JR. M.D.
NPI 1649611252
Family Medicine in Harrisburg, IL

Q: What is Charli Smith's NPI number?

The NPI number for Charli Smith is 1649611252. It was assigned to this individual provider in the NPPES registry on July 11, 2013.

Q: What is Charli 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 Charli Smith was last updated on May 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 July 11, 2013PECOS Enrolled

608 ROLLIE MOORE DR, HARRISBURG, IL 62946(618) 252-6150 Get Directions Write a Review

NPPES record last updated: May 13, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 13, 2022, Dec 8, 2020, Nov 13, 2019 and 2 more (5 updates tracked since 2016).

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About Dr. Charli Walter Leroy Smith Jr. M.d. NPPES

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

DR. CHARLI WALTER LEROY SMITH JR. M.D. (NPI 1649611252) is an individual family medicine provider in Harrisburg, Illinois, licensed in Illinois (036139019) and active in the NPI registry since July 2013. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1649611252

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. CHARLI WALTER LEROY SMITH JR.Credential: M.D.

Location Address608 ROLLIE MOORE DRHarrisburg, IL 62946-2351

Mailing Address7209 Moake School RdMarion, IL 62959-7782 · (262) 488-2395

Phone(618) 252-6150

Sole ProprietorNo

Enumeration DateJuly 11, 2013

Last NPPES UpdateMay 13, 20225 updates tracked since enumeration

NPPES CertifiedMay 13, 2022

✔ NPI 1649611252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036139019

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.

Also ListedPreventive Medicine · Undersea and Hyperbaric MedicineTaxonomy 2083P0011X · License 036139019 (IL)

608 ROLLIE MOORE DR, Harrisburg, IL 62946

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Secondary Practice Locations 3

Location 1405 Rushing DrHerrin, IL 62948-3730 · Phone (618) 993-3300 · Fax (618) 993-0262

Location 22 S Hospital DrMurphysboro, IL 62966-3333 · Phone (618) 684-1035 · Fax (618) 684-1036

Location 3315 S 13th St Ste 3Herrin, IL 62948-3666 · Phone (618) 988-6157 · Fax (618) 942-2210

Other Identifiers 1

Other214881IL · Medicare Group

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Charli Walter Leroy Smith Jr. M.d. 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.

Medicare Billing Reassignments

Medicare enrollment records show Charli Smith reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern Illinois Medical Services, Nfp

36 mi

Internal Medicine

1239 E MAIN ST
Carbondale, IL 62901

Reassigned Medicare billing, Illinois enrollment
702 clinicians in this Medicare group

NPI 1770656837 (618) 457-5200

Illinois Department Of Human Services

42 mi

Psychiatric Hospital

1000 N MAIN ST
Anna, IL 62906

Reassigned Medicare billing, Illinois enrollment
46 clinicians in this Medicare group

NPI 1538277637 (618) 833-5161

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62946 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers25 claims62 services$4.54 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers12 claims12 services$46.03 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers44 claims44 services$88.89 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

4 suppliers33 claims33 services$204.71 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

1 supplier23 claims23 services$33.27 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 11

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

MRS. PAMELA R ATKINSON MSN FNP-C

Nurse Practitioner