CHARLES F SMITH (CRNA) – Anesthesiology Physician, NPI 1104043512

CHARLES F SMITH (CRNA) is a healthcare provider. based in Janesville, Wisconsin. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 109611 (WI). The NPI Number for CHARLES F SMITH (CRNA) is 1104043512

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
CHARLES F SMITH (CRNA)
NPI
1104043512
Phone
(608) 756-6000
Address
1000 MINERAL POINT AVE
Enumeration Date
19 April 2007
Last Update Date
30 May 2008

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
6088736611
Graduation Year
1997 (29 years ago)
PAC ID
7012818586
Group Practice PAC ID
7012825706
Professional Enrollment ID
I20040128000464
Address ID
WI535891864ST900XXSTXX300
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

1,141 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in WI

Provider Addresses for CHARLES F SMITH (CRNA)

  • 1000 MINERAL POINT AVE

    JANESVILLE, WI 535482940

    Phone: (608) 756-6000

    Mailing address matches the actual address.

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: 2004-01-28

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
I20040128000464ICertified Registered Nurse Anesthetist (Crna)WITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53548)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012825706View full group profile
NameSpecialtyState
Physician AssistantPA
-WI
-WI
Emergency MedicineWI
Internal MedicineIL
-WI
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)IL
Physician AssistantIA
Physician AssistantWI

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Frequently asked questions

Is CHARLES F SMITH (CRNA) listed with a National Provider Identifier?
Yes — CHARLES F SMITH (CRNA) has NPI 1104043512 on file in the registry.
Is there an active status for CHARLES F SMITH (CRNA)?
For scheduling context, CHARLES F SMITH (CRNA) is shown as active in the registry.
What clinical focus is listed for CHARLES F SMITH (CRNA)?
At a glance, CHARLES F SMITH (CRNA) is tied to Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Where in Wisconsin is CHARLES F SMITH (CRNA) registered?
Use Janesville, Wisconsin as the headline location for CHARLES F SMITH (CRNA) here.
When was this NPI issued?
Enumeration for CHARLES F SMITH (CRNA) is noted as April 19, 2007 where the registry provides it.

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