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

Mr. Glenn R Smith, PA-C

Individual provider Medical Physician Assistant · NPI 1275505794

Mr. Glenn R Smith, PA-C is a Physician Assistant in Greenville, North Carolina. Qualified in 2004, 22 years ago. Practices with Vidant Medical Group LLC, a 974-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
22
Licensed in
NC
In the registry since
2006
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 Partly verified

Some contact details are missing from the federal record.

Brody Outpatient Center 600 Moye Blvd
Greenville, NC 27858
Phone: (252) 744-2207
Fax: (252) 744-3794
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 104089 (NC)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 104089 (NC)

Record details

NPI number1275505794
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 7, 2006
Last updated in NPPESJanuary 8, 2022
Certification dateJanuary 8, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Vidant Medical Group Llc — 974 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Greenville