Delmar Wallace Smith, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-265 Issued in ID

Practice address

2000 American Legion Blvd
Mountain Home, ID 83647-3138

Phone

(208) 587-1500

Fax

(208) 587-3180

NPI assigned

Jan 31, 2006

Last updated

Feb 25, 2008By the provider in NPPES

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

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Oklahoma College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Doctors Clinic of Elmore County PLLCGroup PAC ID 8224098413, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Horizon Home Health Home health agency, Meridian, ID, CCN 137065
• St Luke's Elmore Medical Center Hospital, Mountain Home, ID, CCN 131311
• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BCEBDD/Endpoint/BCEBDD

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.

• Doctors Clinic of Elmore County PLLC

  • Family Medicine Physician
  • Mountain Home, ID
  • NPI 1063578664
  Medicare reassignment Care Compare group

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

• St Lukes Regional Medical Center

  dba St Lukes Elmore

  • Ambulance
  • Mountain Home, ID
  • NPI 1477954204

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Elmore Medical Center

  • Critical Access Hospital
  • Mountain Home, ID
  • NPI 1699013565
  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• Teton Healthcare, Inc.

  dba Horizon Home Health and Hospice

  • Home Health Agency
  • Meridian, ID
  • NPI 1689996357
  Care Compare affiliation

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1336110980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 AMERICAN LEGION BLVD",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473138",
            "telephone_number": "208-587-1500",
            "fax_number": "208-587-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 AMERICAN LEGION BLVD",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473138",
            "telephone_number": "208-587-1500",
            "fax_number": "208-587-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DELMAR",
        "middle_name": "WALLACE",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda G Shaw, FNP
• Katherine Elizabeth Sheffield, RN
• Colten Young Sicard
• Jenny Rochelle Simison
• Courtney Sinfield
• Jolee A Smith, BSW
• Martin McKay Smith
• Spartan Dental Company, LLC
• St Lukes Clinic-Treasure Valley LLC (St Lukes RHC - Trinity Mountain)
• St Lukes Regional Medical Center (St Lukes Elmore Medical Center Physician Group)

• Medical Physician Assistant in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.