Pamela Smith

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD60964858 Issued in WA

Practice address

620 W 1St St
Wapato, WA 98951-1108

Phone

(509) 877-4111

Fax

(509) 877-7349

NPI assigned

Dec 12, 2006

Last updated

Jan 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Pamela Sue Spencer Other name

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pines Health Services

  • Internal Medicine Physician
  • Caribou, ME
  • NPI 1942277819

  Pediatrics

  Medicare reassignment NPD
• Pines Health Services

  dba Washburn Health Center

  • Federally Qualified Health Center (FQHC)
  • Washburn, ME
  • NPI 1922449834
  NPD
• DHHS PHS Naihs Fort Defiance Hospital

  dba PHS Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1700962131
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Southcentral Foundation

  dba BSD- Detox

  • Multi-Specialty Clinic/Center
  • Anchorage, AK
  • NPI 1255881637
  NPD (past)
• Southcentral Foundation

  dba Tribal/HPG- Benteh Nuutah Primary Care Center (BNPCC)

  • Multi-Specialty Clinic/Center
  • Wasilla, AK
  • NPI 1386680056
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1073673521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W 1ST ST",
            "city": "WAPATO",
            "state": "WA",
            "postal_code": "989511108",
            "telephone_number": "509-877-4111",
            "fax_number": "509-877-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W 1ST ST",
            "city": "WAPATO",
            "state": "WA",
            "postal_code": "989511108",
            "telephone_number": "509-877-4111",
            "fax_number": "509-877-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C10009097",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "52698",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60964858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "SPENCER",
            "middle_name": "SUE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rd LLC (Horizon Pharmacy)
• Monty Ray Rieger, DDS-PHD
• Sara Ann Routt, LSWAIC
• Monica Amy Sanchez, RN, BSN
• Teresa Anne Schott
• Taylor Made Nutrition
• Carol C Taylor, RD
• The Valley Alcohol Council (MERIT Resource Services)
• Total Renal Care Inc (Wapato Dialysis)
• Brian Ullom

• Pediatrics Physician in Wapato, WA
• Providers in Wapato, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.