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

Individual provider Internal Medicine Physician · NPI 1093770299

Shadrach J Smith Jr., MD is an Internal Medicine in Overland Park, Kansas. Graduated from University of Kansas School of Med (KC/WICH/SAL) in 1978, 48 years ago. Offers telehealth. Licensed in Missouri.

Years since qualifying
48
Trained at
University of Kansas School of Med (KC/WICH/SAL)
Licensed in
MO
In the registry since
2006
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

12140 Nall Ave Ste 100
Overland Park, KS 66209
Phone: (913) 451-8500
Fax: (913) 451-1754
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 2000174361 (MO)

Record details

NPI number1093770299
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 19, 2006
Last updated in NPPESJuly 24, 2013

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolUNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated 1978 (48 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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