Louis Michael Smith, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1182 Issued in AK

Practice address

22301 W Alsop Rd
Wasilla, AK 99623-5023

Phone

(907) 864-8100

NPI assigned

Mar 17, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: louis.smith.1@15729.direct.athenahealth.com

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1669898474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22301 W ALSOP RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996235023",
            "telephone_number": "907-864-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22301 W ALSOP RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996235023",
            "telephone_number": "907-864-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LOUIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-17",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "2321",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "1182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1613061",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Smith
• Jermain M Smith, BEHAVIOR ANALYST
• Jesse Gerald Smith III
• Joseph Smith
• Kimberley Ann Smith
• Michelle Smith, PHARMD
• Savannah Smith
• Sawyer R Smith, DPT
• Sonya Mae Smith, LMP
• Stacy Jean Smith, LPC

• Medical Physician Assistant in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Medical Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.