Active NPI
Gregory James Smith, AU.D.
- Audiologist
- Waterloo, IA
National Provider Identifier
1033366604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 1033366604
- Practice address
- 3138 Kimball Ave
Waterloo, IA 50702-5253 - Phone
- (319) 234-4360
- Fax
- (319) 235-5360
- NPI assigned
- Aug 26, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1033366604 | IA | Primary |
Addresses
Primary practice location
3138 Kimball Ave
Waterloo, IA 50702-5253
Mailing address
6700 Washington Ave S
Eden Prairie, MN 55344-3405
Phone (919) 308-1223
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1033366604 | IA | MD | Audiologist |
| 7540 | MN | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772582400000",
"number": "1033366604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6700 WASHINGTON AVE S",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553443405",
"telephone_number": "919-308-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3138 KIMBALL AVE",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025253",
"telephone_number": "319-234-4360",
"fax_number": "319-235-5360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "GREGORY",
"middle_name": "JAMES",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-26",
"last_updated": "2026-03-04",
"certification_date": "2026-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IA",
"license": "1033366604",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.