Stephen Max Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1321 Issued in ID

Practice address

611 Clinic Road
Challis, ID 83226

Phone

(208) 879-4351

Fax

(208) 879-5216

NPI assigned

Dec 19, 2011

Sex

Male

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 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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Challis Area Health Center IncorporatedGroup PAC ID 2769779776, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Steele Memorial Medical Center Hospital, Salmon, ID, CCN 131305
• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13547/brand/1/csg/1/fhir/r4
• Direct secure messaging: s.max.smith.1@13547.direct.athenahealth.com

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.

• Challis Area Health Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Challis, ID
  • NPI 1013387877

  ID

  Medicare reassignment Care Compare group
• Ensign Family Medicine LLC

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1659538247
  NPD
• Challis Area Health Center

  • Medical Physician Assistant
  • Challis, ID
  • NPI 1538251996
  NPD (past)

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

• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794

  Hospital

  Care Compare affiliation
• Steele Memorial Medical Center

  • Critical Access Hospital
  • Salmon, ID
  • NPI 1851403265

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1639448798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980",
            "city": "CHALLIS",
            "state": "ID",
            "postal_code": "832260980",
            "telephone_number": "208-879-4351",
            "fax_number": "208-879-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 CLINIC ROAD",
            "city": "CHALLIS",
            "state": "ID",
            "postal_code": "83226",
            "telephone_number": "208-879-4351",
            "fax_number": "208-879-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "MAX",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-19",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA1321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rainbow'S End Recovery Center LLC
• Cynthia Lee Rathmann, DC
• Sharon Rotax, LMSW
• Round Valley Rehabilitation
• Crystal Marie Smalley, LCSW-I, LMSW
• Cherie L Strand, OTR/L, CHT
• Thayn Physical Therapy, PLLC
• Zhohnann Kathleen Piva Thayn, PT
• Two Rivers Dental, PLLC
• Helen Winegarner, FNP

• All providers in Challis, ID
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.
• 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.