Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Stacy L Smithson, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1063499895

Dr. Stacy L Smithson, MD is an Obstetrics/Gynecology in Lebanon, Kentucky. Graduated from University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb) in 1989, 37 years ago. Practices with Northeastern Nevada Physician Practices LLC, a 20-clinician group and accepts Medicare assignment. Licensed in Kentucky, New Hampshire, Oregon and South Carolina and 1 more.

Years since qualifying
37
Trained at
University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb)
Licensed in
KY, NH, OR, SC, TN
In the registry since
2005
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

320 N Loretto Rd
Lebanon, KY 40033-1300
Phone: (270) 692-6131
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence C4582 (KY)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 22067 (NH)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 18049 (SC)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence MD198221 (OR)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 68868 (TN)
Specialist Taxonomy 174400000X · Licence 18049 (SC)

Record details

NPI number1063499895
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedDecember 22, 2005
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025
Mailing address1621 W Morris Blvd Ste A, Morristown, TN 37813-2967

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolUNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated 1989 (37 years in practice)
Group practice Northeastern Nevada Physician Practices Llc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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