Individual provider Active NPI

Terry Paul Smith, DPM

  • Podiatrist
  • Salt Lake City, UT
National Provider Identifier
1013972157
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1027420501 Issued in UT
Practice address
82 S 1100 E
Suite 300
Salt Lake City, UT 84102-1686
Phone
(801) 505-5277
Fax
(801) 505-5280
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1027420501 UT Primary

Addresses

Primary practice location

82 S 1100 E
Suite 300
Salt Lake City, UT 84102-1686

Mailing address

PO Box 540610
N Salt Lake, UT 84054-0610
Phone (801) 451-6060

Other identifiers 1

IdentifierTypeStateIssuer
1013972157MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1027420501UTMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1013972157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 540610",
            "city": "N SALT LAKE",
            "state": "UT",
            "postal_code": "840540610",
            "telephone_number": "801-451-6060",
            "fax_number": "801-451-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 S 1100 E",
            "address_2": "SUITE 300",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021686",
            "telephone_number": "801-505-5277",
            "fax_number": "801-505-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TERRY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "1027420501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013972157",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; 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.