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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. CONNOR MITCHELL SMITH MD
NPI 1720601149
Student in an Organized Health Care Education/Training Program in Fayetteville, GA

Active since May 20, 2020PECOS Enrolled
1240 HIGHWAY 54 W STE 710, FAYETTEVILLE, GA 30214(770) 991-2800 Get Directions Write a Review

NPPES record last updated: September 18, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Sep 18, 2026, Sep 2, 2026, May 20, 2020 (3 updates tracked since 2020).

About Dr. Connor Mitchell Smith Md NPPES

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

DR. CONNOR MITCHELL SMITH MD (NPI 1720601149) is an individual student in an organized health care education/training program in Fayetteville, Georgia, licensed in Michigan (4351046295) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS and is a graduate of Howard University College Of Medicine (2020).

NPPES Registry Identity

NPI1720601149
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. CONNOR MITCHELL SMITHCredential: MD
Location Address1240 HIGHWAY 54 W STE 710Fayetteville, GA 30214-4565
Mailing Address1240 Highway 54 W Ste 710Fayetteville, GA 30214-4565 · (770) 991-2800
Phone(770) 991-2800
Sole ProprietorNo
Medical School CMSHoward University College Of MedicineGraduated 2020
Enumeration DateMay 20, 2020
Last NPPES UpdateSeptember 18, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 18, 2026
✔ NPI 1720601149 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
License✔ Licensed in MI · 4351046295
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.
1240 HIGHWAY 54 W STE 710, Fayetteville, GA 30214
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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)

Dr. Connor Mitchell Smith Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9638590615
PECOS Enrollment IDI20260612001928
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 9

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

ASHLEY ELIZABETH RADCLIFFE AU.D
Audiologist
1240 HIGHWAY 54 W STE 710
FAYETTEVILLE, GA 30214
Fayette County (770) 991-2800
MS. MAURISHA TAYLOR PA
Physician Assistant
1240 HIGHWAY 54 W STE 710
FAYETTEVILLE, GA 30214
Fayette County (770) 991-2800
MICHAEL JOHN SYLVESTER MD
Otolaryngology (Otolaryngic Allergy)
1240 HIGHWAY 54 W STE 710
FAYETTEVILLE, GA 30214
Fayette County (770) 991-2800
SHELBY LAUREN WADSWORTH PA-C
Physician Assistant
1240 HIGHWAY 54 W STE 710
FAYETTEVILLE, GA 30214
Fayette County (770) 991-2800
SOUTH ATLANTA EAR NOSE & THROAT, PC
Specialist
1240 HIGHWAY 54 W STE 710
FAYETTEVILLE, GA 30214
Fayette County (770) 991-2800
DR. LINDSAY B HAYAT AU.D.
Audiologist
1240 HIGHWAY 54 W STE 710
FAYETTEVILLE, GA 30214
Fayette County (770) 461-2124
DR. MICHELE CHANCE AU.D.
Audiologist
1240 HIGHWAY 54 W STE 710
FAYETTEVILLE, GA 30214
Fayette County (770) 991-2800
MRS. SHEENA POWELL MANDERS PA-C
Physician Assistant
1240 HIGHWAY 54 W STE 710
FAYETTEVILLE, GA 30214
Fayette County (770) 991-2800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Connor Smith's NPI number?

The NPI number for Connor Smith is 1720601149. It was assigned to this individual provider in the NPPES registry on May 20, 2020.

Where is Connor Smith located?

Connor Smith practices at 1240 Highway 54 W Ste 710, Fayetteville, GA 30214. The listed phone number is (770) 991-2800.

What is Connor Smith's specialty?

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

Is Connor Smith enrolled in Medicare?

Yes. Connor Smith is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Connor Smith was last updated on September 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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.