Terry a. Smith M.C.P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

7350 Issued in MT

Legal business name

TERRY A. SMITH M.C.P.C.

Practice address

310 Spruce St
Superior, MT 59872-9680

Phone

(406) 822-4100

NPI assigned

Sep 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Terry Allen Smith, D.O.

Title

Owner

Phone

(406) 822-4100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• ponderosa medical clinic Doing business as

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

{
    "created_epoch": "1190419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1932395084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 SPRUCE ST",
            "address_2": "PO BOX 340",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "598729680",
            "telephone_number": "406-822-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 SPRUCE ST",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "598729680",
            "telephone_number": "406-822-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY A. SMITH M.C.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-22",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-822-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MT",
            "license": "7350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "97711",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0066521",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ponderosa medical clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victor Labarre Stampley, LCSW
• Nardy Stascavage, CRNA
• Superior Elementary School
• Superior High School
• Superior Volunteer Fire Company Inc
• Threshold Movement Therapy & Coaching, PLLC
• Alexis Vantiem, PA-C
• Jacob Whetzel
• Gary Tibbett Woodson, R.PH.

• Clinic/Center in Superior, MT
• Providers in Superior, MT by specialty
• Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.