NPIMap

Individual provider Active NPI

Bryan Sean Smithson, MD

  • Family Medicine Physician
  • Show Low, AZ
National Provider Identifier
1336377464
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45758 Issued in AZ
Practice address
5300 S Sutter Dr Ste a
Show Low, AZ 85901-8054
Phone
(928) 251-4244
Fax
(833) 539-1739
NPI assigned
Jun 26, 2009
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 45758 AZ Primary

Addresses

Primary practice location

5300 S Sutter Dr Ste a
Show Low, AZ 85901-8054

Mailing address

5300 S Sutter Dr Ste a
Show Low, AZ 85901-8054
Phone (928) 251-4244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20120724000101 AZ Practitioner - Family Practice 4385838200 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
White Mountain Regional Medical CenterGroup PAC ID 1951203512, 16 clinicians
Hospitalist Medicine Healthcare LLCGroup PAC ID 5193948867, 13 clinicians
Premier Mountain Healthcare LLCGroup PAC ID 4486058930, 10 clinicians

Practice addresses (Care Compare)

118 S Mountain Ave
Springerville, AZ 85938-5104
Phone (928) 333-4368

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (302) 354-5471

5300 S Sutter Dr
Unit a
Show Low, AZ 85901-8374
Phone (928) 251-4244

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45758AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Mountain Healthcare LLC Family Medicine Current Accepting new patients
Hospitalist Medicine Healthcare LLC CurrentSince Apr 1, 2014 Accepting new patients
White Mountain Regional Medical Center CurrentSince Apr 1, 2021 Accepting new patients
Premier Mountain Healthcare LLC CurrentSince Aug 1, 2021 Accepting new patients
Scott Hanson Pac Past Accepting new patients
Summit Healthcare Association Past Accepting new patients
East Valley Psychiatry LLC Past Accepting new patients

Locations

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

5300 S Sutter Dr
Unit A
Show Low, AZ 85901
Phone (928) 251-4244

118 S Mountain Ave
Springerville, AZ 85938
Phone (928) 333-4368

Interoperability endpoints

  • Direct secure messaging: bryan.smithson.1@24099.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/24099/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 6

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1336377464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 S SUTTER DR STE A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859018054",
            "telephone_number": "928-251-4244",
            "fax_number": "833-539-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 S SUTTER DR STE A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859018054",
            "telephone_number": "928-251-4244",
            "fax_number": "833-539-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHSON",
        "first_name": "BRYAN",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "45758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.