Individual provider Active NPI

Camille Smith, D.O.

  • Family Medicine Physician
  • Twin Falls, ID
National Provider Identifier
1598846826
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-0503 Issued in ID
Practice address
370 N Haven Dr
Ste 101
Twin Falls, ID 83301-5788
Phone
(208) 733-1112
Fax
(208) 732-1212
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-0503 ID Primary
Family Medicine Physician 207Q00000X TL-2146 CO

Addresses

Primary practice location

370 N Haven Dr
Ste 101
Twin Falls, ID 83301-5788

Mailing address

370 N Haven Dr
Ste 101
Twin Falls, ID 83301-5788
Phone (208) 732-2200

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090707000596 ID Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 3375694102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Camille Smith DO PAGroup PAC ID 1254646318, 2 clinicians

Practice addresses (Care Compare)

370 N Haven Dr
Suite 101
Twin Falls, ID 83301-6023
Phone (208) 733-1112

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL-2146COMDFamily Medicine Physician
O-0503IDMDFamily Medicine Physician

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1598846826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 N HAVEN DR",
            "address_2": "STE 101",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015788",
            "telephone_number": "208-732-2200",
            "fax_number": "208-732-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 N HAVEN DR",
            "address_2": "STE 101",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015788",
            "telephone_number": "208-733-1112",
            "fax_number": "208-732-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAMILLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-0503",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "TL-2146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.