Sandra L Smith, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD61154801 Issued in WA

Practice address

200 NE Mother Joseph PL Ste 420
Vancouver, WA 98664-3203

Phone

(360) 514-6161

Fax

(360) 514-6140

NPI assigned

Mar 16, 2006

Sex

Female

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1992774525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-398-6248",
            "fax_number": "402-829-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 420",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643203",
            "telephone_number": "360-514-6161",
            "fax_number": "360-514-6140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7710 Mercy Rd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681242323",
            "country_code": "US",
            "telephone_number": "420-717-4900",
            "fax_number": "402-717-6064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 NE Mother Joseph Pl Ste 420",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643203",
            "country_code": "US",
            "telephone_number": "360-514-3979",
            "fax_number": "360-729-3482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SANDRA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "29835",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61154801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4645836",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "000370031",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4337963",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ross Edward Smith, M.D., J.D.
• Ryan Allan Smith
• Ryanne Smith
• Samantha Brett Smith
• Samuel Smith, DC
• Sara Joann Smith, AAC
• Sarah Smith
• Sarah Goldie Dubinett Smith, DVM
• Sharon Elizabeth Smith
• Telisa Smith

• Surgery Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.