Lisa Marie Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9138975-8906 Issued in UT

Practice address

500 Foothill Dr
Salt Lake City, UT 84148-0001

Phone

(801) 582-1565

NPI assigned

Aug 29, 2014

Sex

Female

Sole proprietor

No

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

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• University of Utah Community Physicians Group

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1467241554
  Medicare reassignment
• University of Utah Community Physicians Group

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1124422126
  NPD

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1588064315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-582-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-582-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "9138975-8906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Michael Smith, MD
• Leann Schow Smith, M.S., CCC-SLP
• Lindsay Smith
• Lindsay Louise Smith, DPT
• Lisa Smith
• Logan P Smith
• Lonnie Doyle Smith, PHARMD
• Madeleine Smith
• Madeleine Smith
• Madison Smith

• Physician Assistant in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.