Active NPI
Scott P Smith, M.D.
- Emergency Medicine Physician
- Council Bluffs, IA
National Provider Identifier
1669582656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 33039
- Practice address
- 933 E Pierce St
Council Bluffs, IA 51503-4626 - Phone
- (712) 396-6111
- NPI assigned
- Aug 30, 2006
- Last updated
- Jul 1, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 21246 | NE | |
| Emergency Medicine Physician | 207P00000X | 33039 | IA | Primary |
Addresses
Primary practice location
933 E Pierce St
Council Bluffs, IA 51503-4626
Mailing address
PO Box 2797
Omaha, NE 68103-2797
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669582656 | Medicaid | IA | |
| 0218602 | Medicaid | IA | |
| 47037660412 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21246 | NE | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Health System | Emergency Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Covenant Medical Center
- Psychiatric Hospital
- Lubbock, TX
- NPI 1033272497
Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372636800000",
"number": "1669582656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2797",
"city": "OMAHA",
"state": "NE",
"postal_code": "681032797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 E PIERCE ST",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515034626",
"telephone_number": "712-396-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SCOTT",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2013-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NE",
"license": "21246",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IA",
"license": "33039",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1669582656",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0218602",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47037660412",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.