Active NPI
South Routt Medical Center Health Service District
- Family Medicine Physician
- Oak Creek, CO
National Provider Identifier
1790799104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 27550
- Legal business name
- SOUTH ROUTT MEDICAL CENTER HEALTH SERVICE DISTRICT
- Practice address
- 300 Main Street
Oak Creek, CO 80467 - Phone
- (970) 736-8118
- NPI assigned
- Jul 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel H Smilkstein, M.D.
- Title
- Medical Director
- Phone
- (970) 736-8118
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 27550 | CO | Primary |
Addresses
Primary practice location
300 Main Street
Oak Creek, CO 80467
Mailing address
PO Box 8
Oak Creek, CO 80467-0008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070205000528 | CO | Part B Supplier - Clinic/Group Practice | 4880696822 |
Receives reassigned benefits from 5 practitioners Practice locations: Oak Creek, CO |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D0983756 | South Routt Medical Center | Compliance | Jul 31, 2026 |
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://api.platform.athenahealth.com/7204/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
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- Oak Creek, CO
- NPI 1457790453
-
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- Newport, KY
- NPI 1386987568
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638403200000",
"number": "1790799104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8",
"city": "OAK CREEK",
"state": "CO",
"postal_code": "804670008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MAIN STREET",
"city": "OAK CREEK",
"state": "CO",
"postal_code": "80467",
"telephone_number": "970-736-8118"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH ROUTT MEDICAL CENTER HEALTH SERVICE DISTRICT",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-28",
"last_updated": "2021-12-02",
"certification_date": "2021-12-02",
"status": "A",
"authorized_official_last_name": "SMILKSTEIN",
"authorized_official_first_name": "DANIEL",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "970-736-8118",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CO",
"license": "27550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Creek, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.