Vicki P. Smythe, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1209-023 Issued in WI

Practice address

74 Eclipse Ctr
Beloit, WI 53511-3550

Phone

(608) 361-0311

Fax

(608) 361-0312

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  NPD

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1073630711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N GARFIELD AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535451842",
            "fax_number": "608-756-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 ECLIPSE CTR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535113550",
            "telephone_number": "608-361-0311",
            "fax_number": "608-361-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTHE",
        "first_name": "VICKI",
        "middle_name": "P.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1209-023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Jo Skowronski, CD
• Amber Noel Slaybaugh, DPT
• Kari Ann Smith, PTA
• Seth James Smith
• Shayla D.C. Smith, AU.D.
• Caitlyn Socha
• Stacey Lee Solomon
• Vijaya Somaraju, M.D.
• Southern Wisconsin Emergency Associates SC
• Raymond K Spade, SAC

• Medical Physician Assistant in Beloit, WI
• Providers in Beloit, WI by specialty
• Medical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.