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

Mark Samuel Smith, PA-C

Individual provider Physician Assistant · NPI 1629321021

Mark Samuel Smith, PA-C is a Physician Assistant in Abingdon, Virginia. Graduated from Lincoln Memorial University Medical Department in 2012, 14 years ago. Practices with Southeastern Intensivist Services PC, a 237-clinician group and accepts Medicare assignment. Licensed in Tennessee and Virginia.

Years since qualifying
14
Trained at
Lincoln Memorial University Medical Department
Licensed in
TN, VA
In the registry since
2012
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

16000 Johnston Memorial Dr Fourth Fl
Abingdon, VA 24211-7659
Phone: (276) 258-4050
Fax: (276) 258-4056
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110004485 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 2210 (TN)

Record details

NPI number1629321021
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 23, 2012
Last updated in NPPESFebruary 23, 2017
Mailing address16000 Johnston Memorial Dr, Fourth Floor, Abingdon, VA 24211-7659

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated 2012 (14 years in practice)
Group practice Southeastern Intensivist Services Pc — 237 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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