Organization Active NPI

Russell a Smith, MD PC

  • Health Service Clinic/Center
  • Sandy, UT
National Provider Identifier
1588843536
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
4938616-1205 Issued in UT
Legal business name
RUSSELL A SMITH, MD PC
Practice address
9600 S 1300 E Ste 40 Sandy, Ut 84094
300
Sandy, UT 84094-3762
Phone
(801) 571-7777
Fax
(801) 523-1848
NPI assigned
Oct 26, 2007
Last updated
Mar 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Authorized official

Name
Dr. Russell A Smith, M.D.NPI 1427018290
Title
Physician
Phone
(801) 571-7777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 4938616-1205 UT Primary

Addresses

Primary practice location

9600 S 1300 E Ste 40 Sandy, Ut 84094
300
Sandy, UT 84094-3762

Mailing address

9600 S 1300 E Ste 40 Sandy, Ut 84094
300
Sandy, UT 84094-3762
Phone (801) 571-7777

Other identifiers 2

IdentifierTypeStateIssuer
528709718013MedicaidUT
566022964002MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050131000421 UT Part B Supplier - Clinic/Group Practice 5496705170 Receives reassigned benefits from 1 practitioner
Practice locations: Sandy, UT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D0992375Russell a Smith MD9600 S 1300 E #230, Sandy, UT 84094Provider-performed microscopyOct 14, 2027

National Provider Directory

National Provider Directory

Locations

9600 S 1300 E
#300
Sandy, UT 84094
Phone (801) 571-7777

9660 S 1300 E
Ste 40
Sandy, UT 84094

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1588843536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 S 1300 E STE 40 SANDY, UT 84094",
            "address_2": "300",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943762",
            "telephone_number": "801-571-7777",
            "fax_number": "801-523-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 S 1300 E STE 40 SANDY, UT 84094",
            "address_2": "300",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943762",
            "telephone_number": "801-571-7777",
            "fax_number": "801-523-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL A SMITH, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "801-571-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "UT",
            "license": "4938616-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528709718013",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "566022964002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.