Russell M Smith, MD
Individual provider Active NPI Emergency Medicine Physician · White Salmon, WA
NPI 1669440772 · NPPES record last updated Mar 9, 2012
Key facts
- NPI
- 1669440772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- MD00029546 (WA)
- Practice address
- 211 Skyline Drive
White Salmon, WA 98672 - Phone
- (509) 493-1101
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- University of California, Geffen School of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Klickitat County Public Hospital District No 1
Practice addresses (Care Compare)
310 S Roosevelt St
Goldendale, WA 98620-9201
Phone (509) 486-2151
Hospital & facility affiliations
- Klickitat Valley Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150304000307 | WA | Practitioner - Emergency Medicine | 7416273792 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD14453 | OR | MD | Emergency Medicine Physician |
| MD00029546 | WA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Klickitat County Public Hospital District No 1 | Current |
Accepting new patients | |
| Klickitat County Public Hospital District No 1 | Current |
Accepting new patients | |
| Klickitat County Public Hospital District No 1 | Current | Accepting new patients | |
| Public Hospital District No. 2, Klickitat County, Washington | Current | Accepting new patients | |
| Public Hospital District No 2, Klickitat County, Washington | Current |
Accepting new patients | |
| Public Hospital District No 2, Klickitat County Washington | Current |
Accepting new patients |
Locations
317 Sanders Way
Goldendale, WA 98620
Phone (509) 773-4017
310 S Roosevelt St
Goldendale, WA 98620
Phone (509) 486-2151
212 NE Skyline Dr
White Salmon, WA 98672
Phone (509) 493-2133
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD00029546 | WA | Yes |
| Emergency Medicine Physician | 207P00000X | MD14453 | OR |
Addresses
Primary practice location
211 Skyline Drive
White Salmon, WA 98672
Mailing address
16506 SW 29TH Street Apt K93
Vancouver, WA 98683
Phone (509) 493-1101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8117327 | Medicaid | WA | |
| 105593 | Medicaid | OR | |
| 2081666 | Medicaid | NV | |
| XPY196668 | Medicaid | CA |
Other providers in White Salmon, WA
- Jennifer Lee Silapie
- Elizabeth A Siller
- Shelly Skiles
- Jordan Lundy Slaughter
- Leslie Smith
- Deborah K Sneed
- Staci L Hanson DMD PC
- Connie Strom
- Allison Sturges
- Ericka Sullivan
All providers in White Salmon, WA · Emergency Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.