Individual provider Active NPI

Cameron G Smith, DO

  • Family Medicine Physician
  • Provo, UT
National Provider Identifier
1760019699
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12438118-1204 Issued in UT
Practice address
589 S State St
Provo, UT 84606-5056
Phone
(801) 420-2000
NPI assigned
Mar 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12438118-1204 UT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

589 S State St
Provo, UT 84606-5056

Mailing address

589 S State St
Provo, UT 84606-5056
Phone (801) 420-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220606002118 UT Practitioner - Family Practice 4981082898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Campbell Univ School of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountainlands Community Health Center IncGroup PAC ID 6305872201, 16 clinicians

Practice addresses (Care Compare)

589 S State St
Provo, UT 84606-5056
Phone (801) 429-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
12438118-1204UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainlands Community Health Center, Inc. Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Feb 24, 2022 Accepting new patients
Ihc Health Services, Inc. CurrentSince Feb 24, 2022 Accepting new patients
Mountainlands Community Health Center, Inc Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Mountainlands Community Health Center, Inc Family Medicine Current Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

98 N 1100 E
Ste 101
Highland, UT 84003
Phone (801) 492-2273

589 S State St
Provo, UT 84606
Phone (801) 420-2000

395 W Cougar Blvd
Ste 205
Provo, UT 84604
Phone (801) 357-1770

475 W 940 N
Provo, UT 84604
Phone (801) 357-7909

Interoperability endpoints

  • Direct secure messaging: cameron.smith.1@11721.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1760019699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056",
            "telephone_number": "801-420-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056",
            "telephone_number": "801-420-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAMERON",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "12438118-1204",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.