Individual provider Active NPI

David A Smith, MD

  • Family Medicine Physician
  • Boise, ID
National Provider Identifier
1336337708
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M5762 Issued in ID
Practice address
5985 W State St
Boise, ID 83703-3039
Phone
(208) 853-0071
Fax
(208) 853-9422
NPI assigned
Oct 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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 M5762 ID Primary

Addresses

Primary practice location

5985 W State St
Boise, ID 83703-3039

Mailing address

5985 W State St
Boise, ID 83703-3039
Phone (208) 853-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5762IDMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1336337708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5985 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033039",
            "telephone_number": "208-853-0071",
            "fax_number": "208-853-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5985 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033039",
            "telephone_number": "208-853-0071",
            "fax_number": "208-853-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M5762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.