Individual provider Active NPI

Courtney Smith, PA-C

  • Physician Assistant
  • Meridian, ID
National Provider Identifier
1558815670
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1367 Issued in ID
Practice address
3280 E Lanark Dr
Meridian, ID 83642-5982
Phone
(208) 377-4400
Fax
(208) 377-4416
NPI assigned
Aug 5, 2016
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1367 ID Primary

Addresses

Primary practice location

3280 E Lanark Dr
Meridian, ID 83642-5982

Mailing address

PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6500

Other practice location 1

700 Caldwell Blvd
Nampa, ID 83651-1707
Phone (208) 809-2892

Other names 1

  • Courtney Hill Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160823000494 ID Practitioner - Physician Assistant 9931494481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

10482 W Carlton Bay Dr
Garden City, ID 83714-5143
Phone (208) 955-6500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-1367IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Group, LLC CurrentSince Aug 17, 2020 Accepting new patients
Alliance Medical Group, LLC Past Accepting new patients

Locations

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

3280 E Lanark Dr
Meridian, ID 83642
Phone (208) 377-4400

700 Caldwell Blvd
Nampa, ID 83651
Phone (208) 466-6567

Interoperability endpoints

  • Direct secure messaging: courtney.smith@phmg.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1558815670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 E LANARK DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425982",
            "telephone_number": "208-377-4400",
            "fax_number": "208-377-4416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Caldwell Blvd",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836511707",
            "country_code": "US",
            "telephone_number": "208-809-2892",
            "fax_number": "208-809-2893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "COURTNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "HILL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.