A Theodore Smith, PA-C, L.AC.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3118 Issued in CO

Practice address

1600 West 24TH Street
Colorado Mental Health Institute at Pueblo
Pueblo, CO 81003

Phone

(719) 761-1486

NPI assigned

Nov 22, 2010

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 names 1

• Mr. Ted Smith Other name

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rocky Mountain Neuropsychiatric Associates, P.C.Group PAC ID 3375517568, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Rocky Mountain Neuropsychiatric Associates, P.C.

  • Psychiatry Physician
  • Colorado Springs, CO
  • NPI 1588606818
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1871895995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600W 24TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810031411",
            "telephone_number": "719-546-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WEST 24TH STREET",
            "address_2": "COLORADO MENTAL HEALTH INSTITUTE AT PUEBLO",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81003",
            "telephone_number": "719-761-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "A",
        "middle_name": "THEODORE",
        "name_prefix": "Mr.",
        "credential": "PA-C, L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-22",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "3118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TED",
            "last_name": "SMITH",
            "prefix": "MR.",
            "credential": "PA-C, L.AC.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Smile for-Me PLLC
• Smile Four Professionals LLC
• Smile Two, Prof. LLC
• Scott L Smiley, MD
• Wendi Smith Stitt Palomar
• Bradley W Smith, D.O.
• Brady Tucker Smith, DDS
• Catherine Smith, PA
• Christen Smith, RN
• Christine Marie Smith, COTA

• Physician Assistant in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.