Individual provider Active NPI

Clayton Thomas Smith, DO

  • Family Medicine Physician
  • Des Moines, IA
National Provider Identifier
1114282175
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-06605 Issued in IA
Practice address
2353 SE 14TH St
Des Moines, IA 50320-1109
Phone
(515) 248-1400
Fax
(515) 248-1414
NPI assigned
Jul 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO-06605 IA Primary

Addresses

Primary practice location

2353 SE 14TH St
Des Moines, IA 50320-1109

Mailing address

1200 University Ave Ste 200
Des Moines, IA 50314-2355
Phone (515) 248-1447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20240304001037 IA Practitioner - Family Practice 5799094512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Care IncGroup PAC ID 8426966755, 72 clinicians

Practice addresses (Care Compare)

2353 SE 14TH St
Des Moines, IA 50320-1109
Phone (515) 248-1400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Care, Inc. CurrentSince Mar 4, 2024 Accepting new patients
Primary Health Care, Inc. CurrentSince Mar 4, 2024 Accepting new patients
Primary Health Care, Inc. Past Accepting new patients

Locations

2353 SE 14th St
Des Moines, IA 50320
Phone (515) 248-1400

1200 University Ave
Ste 200
Des Moines, IA 50314
Phone (515) 248-1447

Interoperability endpoints

  • Direct secure messaging: csmith0@yourcarecommunity.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1114282175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 UNIVERSITY AVE STE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142355",
            "telephone_number": "515-248-1447",
            "fax_number": "515-248-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2353 SE 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201109",
            "telephone_number": "515-248-1400",
            "fax_number": "515-248-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CLAYTON",
        "middle_name": "THOMAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-05",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-06605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.