Joseph R. Smith, MD

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

MD157761 Issued in OR

Practice address

9290 SE Sunnybrook Blvd Ste 220
Clackamas, OR 97015

Phone

(503) 215-2890

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Joe R. Smith Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1003983818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9290 SE SUNNYBROOK BLVD STE 220",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-215-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOSEPH",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "WA",
            "license": "MD00026122",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "OR",
            "license": "MD157761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500648442",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmith186893@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9290 SE Sunnybrook Blvd Ste 220",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOE",
            "last_name": "SMITH",
            "middle_name": "R.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tami Lynette Smick, MBA, PT
• Kimberley Lynne Smith Daly, BC-DMT, CADC-R, LPC
• Carolyn W. Smith Lin, M.D.
• Amanda Marie Smith, PA-C
• Jenna Smith, PA-C
• La Shawnda T Smith
• Sara Whitney Smith Sr., MSW
• Sean Michael Smith
• Sheryl Lynn Smoke, NP
• Jill Smolevitz, M.D.

• Occupational Medicine Physician in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Occupational Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.