Individual provider Active NPI

Garrett F Smith, PA-C

  • Physician Assistant
  • Kingfield, ME
National Provider Identifier
1811208887
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA001218 Issued in ME
Practice address
25 Depot St
Kingfield, ME 04947-4208
Phone
(207) 265-4555
NPI assigned
Jun 24, 2010
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA001218 ME Primary

Addresses

Primary practice location

25 Depot St
Kingfield, ME 04947-4208

Mailing address

PO Box 727
Waterville, ME 04903-0727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100901000635 ME Practitioner - Physician Assistant 8628192382 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA001218MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Apr 26, 2022 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Oct 1, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Oct 1, 2023 Accepting new patients
Central Maine Medical Center CurrentSince Apr 26, 2022 Accepting new patients
Riverside Eye Center PA CurrentSince Jul 10, 2023 Accepting new patients
Convenientmd - FFS UC LLC Past Accepting new patients
Intermed, PA Past Accepting new patients
Intermed, PA PastSince Mar 20, 1991 Accepting new patients

Locations

600 Center St
Auburn, ME 04210
Phone (207) 783-8951

193 Bath Rd
Brunswick, ME 04011
Phone (207) 424-2272

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

475 Lisbon St
Lewiston, ME 04240
Phone (207) 786-1920

193 Main St
Norway, ME 04268
Phone (207) 743-2544

950 Main St
Westbrook, ME 04092
Phone (207) 517-3800

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1811208887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049030727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 DEPOT ST",
            "city": "KINGFIELD",
            "state": "ME",
            "postal_code": "049474208",
            "telephone_number": "207-265-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GARRETT",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA001218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingfield, ME

Sources for this page

Verify at the official NPI Registry.