Individual provider Active NPI

Martin Lindsey Smart, MD

  • Family Medicine Physician
  • La Pine, OR
National Provider Identifier
1912904202
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD27201 Issued in OR
Practice address
51600 Huntington Rd
La Pine, OR 97739-8887
Phone
(541) 536-3435
Fax
(541) 536-8047
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD27201 OR Primary

Addresses

Primary practice location

51600 Huntington Rd
La Pine, OR 97739-8887

Mailing address

PO Box 3300
La Pine, OR 97739-3300
Phone (541) 536-3435

Other practice location 1

111 NW Larch Ave
Redmond, OR 97756-1322
Phone (541) 923-4462

Other practice location 2

1250 SW Veterans Way Ste 120
Redmond, OR 97756-2588
Phone (541) 923-4462

Other identifiers 1

IdentifierTypeStateIssuer
500633387MedicaidOR

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma District Hospital 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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1912904202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3300",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977393300",
            "telephone_number": "541-536-3435",
            "fax_number": "541-536-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51600 HUNTINGTON RD",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977398887",
            "telephone_number": "541-536-3435",
            "fax_number": "541-536-8047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 NW Larch Ave",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977561322",
            "country_code": "US",
            "telephone_number": "541-923-4462",
            "fax_number": "541-526-1541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 SW Veterans Way Ste 120",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977562588",
            "country_code": "US",
            "telephone_number": "541-923-4462",
            "fax_number": "541-383-1883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMART",
        "first_name": "MARTIN",
        "middle_name": "LINDSEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD27201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500633387",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Pine, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.