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NPI Code Detail

MEDICARE: TONI JOHNETTE ROCKHOLT-SMITH DO

MEDICARE: TONI JOHNETTE ROCKHOLT-SMITH DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician2025-02993NC
2208000000XPediatrics Physician89683SC
3390200000XStudent in an Organized Health Care Education/Training ProgramNM

General Provider Information

NPI Number : 1215566682
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONI JOHNETTE ROCKHOLT-SMITH DO
Provider Business Mailing Address
First Line : 1320 RIBAUT RD
Second Line :
City : PORT ROYAL
State : SC
Zip : 29935-1118
Country : US
Telephone Number : 505-272-5551
Fax Number : 843-986-0900
Provider Business Practice Location Address
First Line : 1200 N ELM ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1004
Country : US
Telephone Number : 336-832-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2020
Last Update Date : 01/12/2026

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Directions to “ TONI JOHNETTE ROCKHOLT-SMITH DO” Practice Location

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