Active NPI
Gary Mark Smith, M.D.
- Psychiatry Physician
- Bellingham, WA
National Provider Identifier
1497715841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD00020599
- Practice address
- 2901 Squalicum Pkwy
Bellingham, WA 98225-1851 - Phone
- (360) 734-5400
- Fax
- (360) 715-6996
- NPI assigned
- Mar 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD00020599 | WA | Primary |
Addresses
Primary practice location
2901 Squalicum Pkwy
Bellingham, WA 98225-1851
Mailing address
PO Box 5096
Bellingham, WA 98227-5096
Phone (360) 734-5400
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497715841 | Medicaid | WA | |
| 5391145 | Other | WA | AETNA |
| 31601 | Other | WA | REGENCE |
| 1001791 | Medicaid | WA | |
| 0178213 | Other | WA | L&I AND CRIME VICTIMS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD00020599 | WA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290124800000",
"number": "1497715841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5096",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982275096",
"telephone_number": "360-734-5400",
"fax_number": "360-715-6996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 SQUALICUM PKWY",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251851",
"telephone_number": "360-734-5400",
"fax_number": "360-715-6996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "GARY",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-27",
"last_updated": "2010-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "MD00020599",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1497715841",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5391145",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "31601",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1001791",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I AND CRIME VICTIMS",
"identifier": "0178213",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.