Timothy B Smith, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3094173-2501 Issued in UT

Practice address

340 MCKB
Provo, UT 84602-5082

Phone

(801) 422-1311

NPI assigned

Jan 20, 2022

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1609528751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 CAMBRIDGE CIR",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044181",
            "telephone_number": "801-318-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MCKB",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846025082",
            "telephone_number": "801-422-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIMOTHY",
        "middle_name": "B",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "3094173-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Smith
• Sonja Nickle Smith, LCSW
• Steven Arthur Smith, PH.D.
• Suzi Smith, RN
• Sydney Nicole Walsh Smith, FNP-C
• Trevor Kent Smith, DO
• Trevor Todd Smith, OD
• Tyler Andrew Smith, M.D.
• Smiths Food & Drug Centers Inc
• Stanley Carl Smoot, PHD

• Clinical Psychologist in Provo, UT
• Providers in Provo, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.