Mattias Wade Smith

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

105411 Issued in OR

Practice address

72C Centennial Loop Ste 100
Eugene, OR 97401-2453

Phone

(541) 972-1824

NPI assigned

Feb 27, 2025

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1265239131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72C CENTENNIAL LOOP STE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012453",
            "telephone_number": "541-972-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72C CENTENNIAL LOOP STE 100",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012453",
            "telephone_number": "541-972-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTIAS",
        "middle_name": "WADE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "105411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth G Smith, PSS
• Keri L Smith, DDS
• Kristen Mae Smith
• Lynae Adrien Smith, R.D., LD
• Marial Claire Smith, LCSW
• Megan Elise Smith
• Melanie Smith
• Michaela Smith
• Misao Smith
• Molly Jane Smith, OTR/L

• Peer Specialist in Eugene, OR
• Providers in Eugene, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.