Dr Stacy L Smithson, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Lebanon, Kentucky. His current practice location is
320 N Loretto Rd, Lebanon, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(270) 692-6131.
Dr Stacy L Smithson is licensed to practice in Kentucky (license number C4582) 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 1063499895.
Physician's Profile
| Full Name | Dr Stacy L Smithson |
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| Gender | Male |
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| Speciality | Obstetrics & Gynecology |
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| Location | 320 N Loretto Rd, Lebanon, Kentucky |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1063499895
- Provider Enumeration Date: 12/22/2005
- Last Update Date: 10/28/2025
Medicare PECOS Information:
- PECOS PAC ID: 1456329002
- Enrollment ID: I20120110000700
Medical Identifiers
Medical identifiers for Dr Stacy L Smithson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063499895 | NPI | - | NPPES |
| I80496 | Medicaid | SC | |
| GP3644 | Medicaid | SC | |
| Q084683 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207V00000X | Obstetrics & Gynecology | 22067 (New Hampshire) | Secondary |
| 207V00000X | Obstetrics & Gynecology | C4582 (Kentucky) | Primary |
| 207V00000X | Obstetrics & Gynecology | 18049 (South Carolina) | Secondary |
| 207V00000X | Obstetrics & Gynecology | MD198221 (Oregon) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 68868 (Tennessee) | Secondary |
| 174400000X | Specialist | 18049 (South Carolina) | Secondary |
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. Dr Stacy L Smithson allows following entities to bill medicare on his behalf.
| Entity Name | Lake Murray Obgyn |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003974171
PECOS PAC ID: 2567430176
Enrollment ID: O20040922000009 |
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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. Dr Stacy L Smithson 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 |
|---|
Dr Stacy L Smithson, MD
1621 W Morris Blvd Ste A,
Morristown, TN 37813-2967
Ph: (423) 492-7100 | Dr Stacy L Smithson, MD
320 N Loretto Rd,
Lebanon, KY 40033-1300
Ph: (270) 692-6131 |
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