Clyde Wendell Smith, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0420010955 Issued in VT

Practice address

44 S Main St
Randolph, VT 05060-1381

Phone

(802) 728-7000

Fax

(802) 728-2394

NPI assigned

Aug 28, 2006

Sex

Male

Sole proprietor

No

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

Doctor of Medicine

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1164530416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050602000",
            "telephone_number": "802-728-7000",
            "fax_number": "802-728-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 S MAIN ST",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050601381",
            "telephone_number": "802-728-7000",
            "fax_number": "802-728-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CLYDE",
        "middle_name": "WENDELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "0420010955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003808",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Singer Eye Center, P.C.
• Sandra Singer, MA
• Heather Slater, HSD
• Elizabeth Small, MA
• Breanna Smith, BS
• Darrell Smith, BS
• Ed R Smith, M.D.
• Kyle Steven Smith, RPH
• Maury D. Smith Jr., M.D.
• Soares Ocular Surgery

• Emergency Medicine Physician in Randolph, VT
• Providers in Randolph, VT by specialty
• Emergency Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.