BRANDON MICHAEL SMITH (NPI# 1558611822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558611822 |
| Entity Type | Individual |
| Full Name | BRANDON MICHAEL SMITH |
| Credential | PA C |
| Practice Address |
1090 W Park Pl Coeur D Alene ID 83814-2785 |
| Mailing Address |
Po Box 1387 Hayden ID 83835-1387 |
| Practice Telephone | 2082152005 |
| Practice Fax Number | 8448073782 |
| Mailing Telephone | 2084150299 |
| Mailing Fax Number | 2086252070 |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2019-03-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA1449 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA176068 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457967556 | Brandon Shane Smith | Registered Nurse | 2630 Dumaine St, New Orleans, LA 70119-3420 | 2020-09-23 |
| 1255947255 | Brandon Smith | Nurse Practitioner | 5067 Camden St, Chubbuck, ID 83202-3501 | 2020-09-16 |
| 1982248530 | Brandon Smith | Massage Therapist | 1324 Stoystown Rd, Friedens, PA 15541-7504 | 2019-11-06 |
| 1114583432 | Brandon Tyler Smith | Student in an Organized Health Care Education/Training Program | 21 Bronson Way, Skillman, NJ 08558-1657 | 2019-05-13 |
| 1619438173 | Brandon Covington Smith | Student in an Organized Health Care Education/Training Program | 727 Westwood Plaza, Dept of Internal Medicine, Los Angeles, CA 90095 | 2019-03-27 |
| 1881163988 | Brandon Scott Smith | Counselor | 350 S Irwin Road, Holland, OH 43528 | 2018-11-19 |
| 1609386580 | Brandon D Smith | Respite Care | 686 Wischer Dr, Taylor Mill, KY 41015 | 2017-10-05 |
| 1558886242 | Brandon Jay Smith | Military Health Care Provider | E Street Bldg G770, Camp Lejeune, NC 28540 | 2017-08-03 |
| 1801333471 | Brandon Smith | Specialist/Technologist | 133 Eagle Ct, Mooresville, NC 28117-8022 | 2017-01-20 |
| 1376959932 | Brandon L. Smith | Dentist | 738 E Spring St, Cookeville, TN 38501-4230 | 2014-07-03 |
| Street Address |
1090 W PARK PL |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083670889 | Jana M Qualls | Nurse Practitioner | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2006-04-21 |
| 1043837685 | Amanda Ament | Dietitian, Registered | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2020-06-30 |
| 1386284958 | Rachel Jones | Counselor | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2020-01-13 |
| 1437715208 | Kristy Handyside | Nurse Practitioner | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2019-05-16 |
| 1144787540 | Laboratory Corporation of America | Clinical Medical Laboratory | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2019-02-22 |
| 1114481140 | Laura J. Haney | Nurse Practitioner | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2019-01-23 |
| 1548736960 | Melanie Jane Moss | Physician Assistant | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2018-10-23 |
| 1467936039 | Laura Bonneville | Counselor | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2018-09-19 |
| 1720564271 | Dirne Health Centers Inc | Counselor | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2018-07-18 |
| 1679003990 | Melinda Janet Soltys | Social Worker | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2017-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023118122 | Heather Sarkis | Physician Assistant | 315 W Dalton Ave, Coeur D Alene, ID 83815-8600 | 2006-09-25 |
| 1841248929 | Stuart T Sharp | Physician Assistant | 2003 Kootenai Health Way Ste 300, Coeur D Alene, ID 83814-6051 | 2006-05-04 |
| 1861484701 | Amanda L Fiola | Physician Assistant | 700 W Ironwood Dr Ste 375, Coeur D Alene, ID 83814-4401 | 2005-08-17 |
| 1508331836 | Justin David Overhoff | Physician Assistant | 980 W Ironwood Dr Ste 104, Coeur D Alene, ID 83814-2668 | 2018-10-13 |
| 1407307259 | Nathan Wheatley | Physician Assistant | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2016-10-17 |
| 1841748530 | Elizabeth St John | Physician Assistant | 700 W Ironwood Dr, Ste 341, Coeur D Alene, ID 83814-2656 | 2016-09-12 |
| 1235521279 | Cody Reese | Physician Assistant | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2015-02-27 |
| 1932503596 | Alison Naomi Wheatley | Physician Assistant | 1090 W Park Pl, Coeur D Alene, ID 83814-2785 | 2014-10-10 |
| 1437553187 | Gretchen Foley | Physician Assistant | 700 W Ironwood Dr, 320, Coeur D Alene, ID 83814-2656 | 2014-10-09 |
| 1891123543 | Henry Petersen | Physician Assistant | 700 W Ironwood Dr, Ste 320, Coeur D Alene, ID 83814-2656 | 2013-10-16 |
| Find all providers in COEUR D ALENE | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
Please comment or provide details below to improve the information on BRANDON MICHAEL SMITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.