Smith Clinic P a

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SMITH CLINIC P A

Practice address

3669 Ellendale Cir
Ammon, ID 83406-4749

Phone

(208) 521-5936

Fax

(208) 524-5608

NPI assigned

Jul 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Oliver D Smith, M.D.

Title

Owner

Phone

(208) 521-5936

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1891993713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3669 ELLENDALE CIRCLE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83406",
            "telephone_number": "208-521-5936",
            "fax_number": "208-524-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3669 ELLENDALE CIR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064749",
            "telephone_number": "208-521-5936",
            "fax_number": "208-524-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH CLINIC P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-521-5936",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Silva, CNIM, REEGT, RPSGT
• Saul Alejandro Silva
• Isac Phil Simpson, D.O.
• Janadell Skidmore, LMSW, ICADC
• Megan Diane Slusher, B.S.
• Debbie Smith, LCSW
• Julie Smith, PHARMACIST
• Michael Brian Smith, NMD, MS
• Randall G. Smith
• Ryan Mark Smith, M.S.

• Family Medicine Physician in Ammon, ID
• Providers in Ammon, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.