Edward Gregory Smith, M.S., CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

HA-1052 Issued in ID

Practice address

921 S 8TH Ave Stop 8116
Pocatello, ID 83209-0002

Phone

(208) 282-3495

Fax

(208) 282-4571

NPI assigned

Oct 10, 2008

Last updated

Oct 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223596800000",
    "number": "1457502288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 W SUNDANCE RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832047418",
            "telephone_number": "208-233-3435",
            "fax_number": "208-232-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 S 8TH AVE STOP 8116",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832090002",
            "telephone_number": "208-282-3495",
            "fax_number": "208-282-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDWARD",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "M.S., CCC-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-10",
        "last_updated": "2008-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "ID",
            "license": "HA-1052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smilemakers of Pocatello, PLLC
• Barry M Smith, D.C.
• Brian Matthew Smith, RN
• Caleb Smith
• Deanna Sue Smith, LCSW
• Jessie Dean Smith, D.C.
• Joel C Smith, DDS
• Kathleen Rene Smith, SE202993
• Keri J Smith
• Mandy Smith, PTA

• Audiologist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Audiologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; 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.