Micah Smith, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

10226142 Issued in OR

Practice address

7325 SW Childs Rd
Portland, OR 97224-7713

Phone

(317) 504-0593

NPI assigned

Nov 2, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1992257331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W HAWKINS PKWY",
            "address_2": "APT 4301",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756051723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7325 SW CHILDS RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247713",
            "telephone_number": "317-504-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICAH",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-02",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "10226142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Smith, PHARMD
• Melissa Smith
• Melissa Smith
• Melissa Mott Smith, OTRL
• Melodee Anne Smith, LPC
• Michaela Dee Smith, RBT
• Michelle Smith, M.D.
• Michelle A Smith
• Mikaila Smith
• Mindy Smith

• Athletic Trainer in Portland, OR
• Providers in Portland, OR by specialty
• Athletic Trainer in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.