Sharon Lynn Smith, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA860 Issued in ME

Practice address

1250 Forest Ave
Portland, ME 04103-1884

Phone

(207) 878-3177

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154460632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LONGVIEW DR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032282",
            "telephone_number": "207-232-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 FOREST AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031884",
            "telephone_number": "207-878-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHARON",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC LISENCE",
            "identifier": "PA161",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee Smith, BSN RN
• Rosemarie Smith, MD
• Samantha Danielle Smith, CST
• Shane Smith, OT
• Shannon Smith, CRNA
• Teresa J Smith, OTR/L
• Wendy E Smith, MD
• Wiley Joseph Smith, M.D.
• Antoinette Smothers
• Jacqueline Smyth, DNP

• Surgical Physician Assistant in Portland, ME
• Providers in Portland, ME by specialty
• Surgical Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.