Individual provider Active NPI

W Bret Smith, MD

  • Dermatology Physician
  • St George, UT
National Provider Identifier
1164499836
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
1778031205 Issued in UT
Practice address
383 S 300 E
St George, UT 84770
Phone
(435) 628-2826
Fax
(435) 628-2839
NPI assigned
Mar 2, 2006
Last updated
Jun 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 1778031205 UT Primary

Addresses

Primary practice location

383 S 300 E
St George, UT 84770

Mailing address

383 S 300 E
St George, UT 84770
Phone (435) 628-2826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20060518000056 UT Practitioner - Dermatology 7810985553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
69.3 of 100Reported as group
Quality
36.72
Improvement activities
40
Cost
82.02

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Skin and Cancer LLC CurrentSince Apr 1, 2006 Accepting new patients

Locations

383 S 300 E
St George, UT 84770
Phone (435) 628-2826

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1164499836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 S 300 E",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "84770",
            "telephone_number": "435-628-2826",
            "fax_number": "435-628-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 S 300 E",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "84770",
            "telephone_number": "435-628-2826",
            "fax_number": "435-628-2839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "W",
        "middle_name": "BRET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "1778031205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.