Individual provider Active NPI

Matthew Thomas Smith, RPH

  • Pharmacist
  • Sunnyside, WA
National Provider Identifier
1801189188
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60134853 Issued in WA
Practice address
2010 Yakima Valley Hwy
Sunnyside, WA 98944-1288
Phone
(509) 839-2711
Fax
(509) 839-4768
NPI assigned
May 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60134853 WA Primary

Addresses

Primary practice location

2010 Yakima Valley Hwy
Sunnyside, WA 98944-1288

Mailing address

2010 Yakima Valley Highway
Sunnyside, WA 98944
Phone (509) 839-2711

Other identifiers 1

IdentifierTypeStateIssuer
PHARMACIST183500000XMedicaidWA

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH60134853WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1801189188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 YAKIMA VALLEY HIGHWAY",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "98944",
            "telephone_number": "509-839-2711",
            "fax_number": "509-839-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 YAKIMA VALLEY HWY",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989441288",
            "telephone_number": "509-839-2711",
            "fax_number": "509-839-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60134853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHARMACIST183500000X",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.