Mr Jimmy Lee Smith Jr, LCSW, LCASA is a medicare enrolled "Social Worker - Clinical" provider in Newton Grove, North Carolina. His current practice location is
194 Holiday Ln, Newton Grove, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(919) 236-9899.
Mr Jimmy Lee Smith Jr is licensed to practice in North Carolina (license number C010442) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1790112175.
Healthcare Provider's Profile
Full Name | Mr Jimmy Lee Smith Jr |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 194 Holiday Ln, Newton Grove, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1790112175
- Provider Enumeration Date: 10/01/2013
- Last Update Date: 03/01/2019
Medicare PECOS Information:
- PECOS PAC ID: 2860767753
- Enrollment ID: I20171003004895
Medical Identifiers
Medical identifiers for Mr Jimmy Lee Smith Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1790112175 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 23353 (North Carolina) | Secondary |
1041C0700X | Social Worker - Clinical | C010442 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Jimmy Lee Smith Jr allows following entities to bill medicare on his behalf.
Entity Name | Carolina Outreach, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1083723266 PECOS PAC ID: 0446449748 Enrollment ID: O20110118000335 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jimmy Lee Smith Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Jimmy Lee Smith Jr, LCSW, LCASA 194 Holiday Ln, Newton Grove, NC 28366-6295 Ph: (919) 236-9899 | Mr Jimmy Lee Smith Jr, LCSW, LCASA 194 Holiday Ln, Newton Grove, NC 28366-6295 Ph: (919) 236-9899 |
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