Organization Active NPI

Stephen D Smith MD PC

  • Gynecology Physician
  • Missoula, MT
National Provider Identifier
1215111679
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
4309 Issued in MT
Legal business name
STEPHEN D SMITH MD PC
Practice address
2825 Fort Missoula Rd
115
Missoula, MT 59804-7420
Phone
(406) 728-4292
Fax
(406) 728-5770
NPI assigned
Dec 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Shannon L Chapla
Title
Office Manager
Phone
(406) 728-4292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X 4309 MT Primary

Addresses

Primary practice location

2825 Fort Missoula Rd
115
Missoula, MT 59804-7420

Mailing address

2825 Fort Missoula Rd
115
Missoula, MT 59804-7420
Phone (406) 728-4292

Other identifiers 1

IdentifierTypeStateIssuer
0043563MedicaidMT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1215111679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 FORT MISSOULA RD",
            "address_2": "115",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047420",
            "telephone_number": "406-728-4292",
            "fax_number": "406-728-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 FORT MISSOULA RD",
            "address_2": "115",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047420",
            "telephone_number": "406-728-4292",
            "fax_number": "406-728-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN D SMITH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "CHAPLA",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "406-728-4292"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MT",
            "license": "4309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0043563",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.