Individual provider Active NPI

Cameron Blayne Smith, DO

  • Student in an Organized Health Care Education/Training Program
  • Albuquerque, NM
National Provider Identifier
1487400693
Registry record updated Jun 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
RS2026-0159 Issued in NM
Practice address
Msc11 6025 1 University of New Mexico
Albuquerque, NM 81731
Phone
(505) 272-5062
Fax
(505) 272-6503
NPI assigned
Apr 29, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2026

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
Student in an Organized Health Care Education/Training Program 390200000X RS2026-0159 NM Primary

Addresses

Primary practice location

Msc11 6025 1 University of New Mexico
Albuquerque, NM 81731

Mailing address

Msc11 6025 1 University of New Mexico
Albuquerque, NM 81731
Phone (505) 272-5062

Other practice location 1

309 E 2nd St
Pomona, CA 91766-1854
Phone (909) 469-5589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260605001777 NM Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 8022589563

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RS2026-0159NMMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780704000000",
    "number": "1487400693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC11 6025 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "81731",
            "telephone_number": "505-272-5062",
            "fax_number": "505-272-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC11 6025 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "81731",
            "telephone_number": "505-272-5062",
            "fax_number": "505-272-6503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917661854",
            "country_code": "US",
            "telephone_number": "909-469-5589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAMERON",
        "middle_name": "BLAYNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-29",
        "last_updated": "2026-06-06",
        "certification_date": "2026-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "RS2026-0159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.