NPIMap

Individual provider Active NPI

Dwight W Smith, MD

  • Family Medicine Physician
  • Klamath Falls, OR
National Provider Identifier
1033122734
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD29203 Issued in OR
Practice address
2821 Daggett Ave Ste 100
Klamath Falls, OR 97601-1106
Phone
(541) 274-6733
Fax
(541) 274-2006
NPI assigned
Aug 14, 2006
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3736 AK
Family Medicine Physician 207Q00000X MD29203 OR Primary

Addresses

Primary practice location

2821 Daggett Ave Ste 100
Klamath Falls, OR 97601-1106

Mailing address

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6564

Other practice location 1

2801 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-4611

Other identifiers 1

IdentifierTypeStateIssuer
MD66291MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090715000358 OR Practitioner - Family Practice 3678625027 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians
Lake Health DistrictGroup PAC ID 4284629221, 56 clinicians

Practice addresses (Care Compare)

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6221

700 S J St
Lakeview, OR 97630-1623
Phone (541) 947-2114

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3736AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince Oct 1, 2014 Accepting new patients
Western Healthcare Services Texas CurrentSince Dec 1, 2022 Accepting new patients
Blue Mountain Hospital District Family Medicine Current Accepting new patients
Blue Mountain Hospital District CurrentSince Aug 1, 2020 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Mar 27, 2017 Accepting new patients

Locations

500 5th St
Brookings, OR 97415
Phone (541) 412-2000

94220 4th St
Gold Beach, OR 97444
Phone (541) 247-3000

170 Ford Rd
John Day, OR 97845
Phone (541) 575-1311

2801 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 274-4510

2821 Daggett Ave
Ste 100
Klamath Falls, OR 97601
Phone (541) 274-4611

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4fb2ef4c-fc22-4675-b38f-5641155a5454/

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sky Lakes Medical CenterKlamath Falls, OR, CCN 380050 Hospital Corporate Director Oct 1, 2014
Sky Lakes Medical Center IncKlamath Falls, OR, CCN 387075 Home health agency Corporate Director Oct 1, 2014

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1033122734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-6564",
            "fax_number": "541-274-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 DAGGETT AVE STE 100",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-274-6733",
            "fax_number": "541-274-2006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Daggett Ave",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976011106",
            "country_code": "US",
            "telephone_number": "541-274-4611",
            "fax_number": "541-274-4218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DWIGHT",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "3736",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD29203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD66291",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.