David Brian Smothers, PSY.D., L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2973-57 Issued in WI

Practice address

10425 W North Ave
Wauwatosa, WI 53226-2416

Phone

(414) 367-9413

Fax

(414) 358-5590

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Milwaukee Psychotherapy Collaborative

  • Clinical Psychologist
  • Milwaukee, WI
  • NPI 1760992788
  NPD (past) Authorized official

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902931132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9120 W HAMPTON AVE STE 212",
            "address_2": "WSPP",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532254960",
            "telephone_number": "414-464-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10425 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262416",
            "telephone_number": "414-367-9413",
            "fax_number": "414-358-5590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9120 W Hampton Ave Ste 212",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532254960",
            "country_code": "US",
            "telephone_number": "414-464-9777",
            "fax_number": "414-358-5590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMOTHERS",
        "first_name": "DAVID",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D., L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3865-125",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2973-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MA 43599400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sophia Smetana Wagner
• Jane Edna Smetana, PTA
• Charlotte Ann Smith, RPH
• Edward B Smith, M.D.
• Scott Smith, RN
• Melissa K Smothers, PH.D.
• Rosemary T Smyczek, MSW
• Linda Snyder
• Lisa M Soboleski, PA
• Yevheniya Sokolova, PHARMD

• Clinical Psychologist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.