DR. BRENT RODERICK SMITH (PSY.D.) – Clinical Psychologist, NPI 1558475012

DR. BRENT RODERICK SMITH (PSY.D.) is a healthcare provider. based in Jackson, Michigan. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. They hold a License No. 6301008782 (MI). The NPI Number for DR. BRENT RODERICK SMITH (PSY.D.) is 1558475012

Main info

Male
Sole Proprietor
36 Years Of Experience
Accepts Medicare Assignment
Name
DR. BRENT RODERICK SMITH (PSY.D.)
NPI
1558475012
Phone
(517) 513-3617
Address
818 Winifred St
Enumeration Date
19 August 2006
Last Update Date
17 August 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5177503869
Graduation Year
1990 (36 years ago)
PAC ID
5193759165
Professional Enrollment ID
I20050920001001
Address ID
MI492019812JA6692XRDXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,216 CLINICAL PSYCHOLOGIST in MI

Provider Addresses for DR. BRENT RODERICK SMITH (PSY.D.)

  • 818 Winifred St

    Jackson, MI 492023062

    Phone: (517) 513-3617

    Fax: (517) 796-3104

    Type: Location

  • Spring Arbor Road, Concord, Concord Township, Jackson County, Michigan, 49237, United States

    JACKSON, MI 492019322

    Phone: (517) 750-3869

    Fax: (517) 750-3673

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-09-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050920001001IClinical PsychologistMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour71731$0
90791Psychiatric diagnostic evaluation1212$0
View full utilization report →

Insurance plans in this area (ZIP 49202)

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Reviews

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Frequently asked questions

How do payers reference DR. BRENT RODERICK SMITH (PSY.D.)?
For DR. BRENT RODERICK SMITH (PSY.D.), use NPI 1558475012 as the unique 10-digit identifier.
Would DR. BRENT RODERICK SMITH (PSY.D.) appear as active to a payer?
You can treat DR. BRENT RODERICK SMITH (PSY.D.) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DR. BRENT RODERICK SMITH (PSY.D.)?
DR. BRENT RODERICK SMITH (PSY.D.)'s specialty line reads Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where in Michigan is DR. BRENT RODERICK SMITH (PSY.D.) registered?
Use Jackson, Michigan as the headline location for DR. BRENT RODERICK SMITH (PSY.D.) here.
When was this NPI issued?
Enumeration for DR. BRENT RODERICK SMITH (PSY.D.) is noted as August 19, 2006 where the registry provides it.

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