Ian B Smith, LMP

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

MA00021875 Issued in WA

Practice address

6223 112TH St E
Puyallup, WA 98373-4316

Phone

(253) 286-2211

NPI assigned

Mar 28, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Baldwin Chiropractic

  • Chiropractor
  • Puyallup, WA
  • NPI 1205090420
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720107212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11723 63RD AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734333",
            "telephone_number": "253-961-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6223 112TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734316",
            "telephone_number": "253-286-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "IAN",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "MA00021875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE PRACTITIONER",
            "identifier": "MA00021875",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Steven Smith, DDS
• Dewayne Rush Smith, DDS
• Ellen Rene Smith, MS CCC-A
• Gina M Smith, BS
• Heather Ashley Smith, LMP
• Jana Rae Smith, OT
• Jody Eliza Smith
• Joshua T Smith, DPM
• Justin Smith, PHARMD
• Karen Alice Smith, RN

• Rehabilitation Chiropractor in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Rehabilitation Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.