Lucas Smith

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Practice address

861 Lakeside Dr
Blackfoot, ID 83221-1674

Phone

(208) 360-7355

NPI assigned

Nov 27, 2023

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1083480404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 LAKESIDE DR",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 LAKESIDE DR",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211674",
            "telephone_number": "208-360-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LUCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preston Oliver Simpson, DC
• Troy Gordon Simpson, DDS
• Smiles 4 Kids Blackfoot PLLC
• Bo Robert Smith
• Dekker Smith, PT, DPT
• Scott Delane Smith, D.C.
• Maryann Smout, DNP, FNP-C
• Snake River Family Services
• Snake River School District 52
• Garrett Lavar Snyder, DPT, PT

• Child Intellectual and/or Developmental Disabilities Respite Care in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.