NPIMap

Organization Active NPI

Matthew J Smith

  • Family Medicine Physician
  • Waterloo, IA
National Provider Identifier
1346877552
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MATTHEW J SMITH
Practice address
1753 W Ridgeway Ave Ste 103a
Waterloo, IA 50701-4521
Phone
(319) 235-3568
NPI assigned
Mar 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Matthew J Smith, MDNPI 1609876507
Title
Owner
Phone
(319) 235-3568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1753 W Ridgeway Ave Ste 103a
Waterloo, IA 50701-4521

Mailing address

PO Box 2818
Waterloo, IA 50704-2818

National Provider Directory

National Provider Directory

Locations

212 W Dale St
Ste 303
Waterloo, IA 50703
Phone (319) 235-3568

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1346877552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2818",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 W RIDGEWAY AVE STE 103A",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014521",
            "telephone_number": "319-235-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW J SMITH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-235-3568",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.