NPIMap

Individual provider Active NPI

Lance Clyde Smith, M.D.

  • Family Medicine Physician
  • Beaver, UT
National Provider Identifier
1295817708
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62664751205 Issued in UT
Practice address
1059 N 100 W
Beaver, UT 84713-1690
Phone
(435) 438-7280
NPI assigned
Oct 20, 2006
Last updated
Nov 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 62664751205 UT Primary

Addresses

Primary practice location

1059 N 100 W
Beaver, UT 84713-1690

Mailing address

PO Box 1690
Beaver, UT 84713-1690
Phone (435) 438-7280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061218000542 UT Practitioner - Family Practice 0244239374 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Ohio, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaver Medical, LLCGroup PAC ID 2365352036, 9 clinicians

Practice addresses (Care Compare)

1059 N 100
Beaver, UT 84713-7758
Phone (435) 438-7280

850 N Main
Milford, UT 84751-0640
Phone (435) 387-2471

PO Box
Suite 1690
Beaver, UT 84713-1690

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions14
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62664751205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Valley Hospital CurrentSince Jan 1, 2026 Accepting new patients
Beaver Medical, LLC CurrentSince Sep 1, 2006 Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f694aea7-f3a7-40e8-9148-3e4c7d86718c/
  • Direct secure messaging: lance.smith@bmc.cernerdirect.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Beaver/ Milford Medical ClinicMilford, UT, CCN 463991 Rural health clinic 5% Or Greater Direct Ownership Interest (33%) Jan 1, 2010
Parowan Medical ClinicParowan, UT, CCN 463820 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2010
Beaver Medical, LLCBeaver, UT, CCN 463810 Rural health clinic 5% Or Greater Direct Ownership Interest (33%) Jan 1, 2010

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1295817708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1690",
            "city": "BEAVER",
            "state": "UT",
            "postal_code": "847131690",
            "telephone_number": "435-438-7280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 N 100 W",
            "city": "BEAVER",
            "state": "UT",
            "postal_code": "847131690",
            "telephone_number": "435-438-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LANCE",
        "middle_name": "CLYDE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "62664751205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver, UT

Sources for this page

Verify at the official NPI Registry.