Individual provider Active NPI

Madeline Emily Smith

  • Physician Assistant
  • Sandy, UT
National Provider Identifier
1992564116
Registry record updated Nov 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14311625-1206 Issued in UT
Practice address
3062 E Dimple Dell Cir
Sandy, UT 84092-4584
Phone
(443) 684-1948
NPI assigned
Mar 18, 2024
Last updated
Nov 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14311625-1206 UT Primary

Addresses

Primary practice location

3062 E Dimple Dell Cir
Sandy, UT 84092-4584

Mailing address

3062 E Dimple Dell Cir
Sandy, UT 84092-4584
Phone (443) 684-1948

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793577600000",
    "number": "1992564116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3062 E DIMPLE DELL CIR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840924584",
            "telephone_number": "443-684-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3062 E DIMPLE DELL CIR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840924584",
            "telephone_number": "443-684-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MADELINE",
        "middle_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2026-11-02",
        "certification_date": "2026-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14311625-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2026; 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.