PRESTON S SMITH (NPI# 1992794929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992794929 |
| Entity Type | Individual |
| Full Name | PRESTON S SMITH |
| Other Name | SCOTT SMITH |
| Credential | PA-C |
| Practice Address |
215 E Hawaii Ave Nampa ID 83686-6011 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2084685930 |
| Practice Fax Number | 2084633044 |
| Mailing Telephone | 2083812222 |
| Mailing Fax Number | 2084633044 |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2013-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA464 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD | 000010145449 | 01 |
| ID | BLUE CROSS | PAG001 | 01 |
| ID | BLUE SHIELD | 000010145450 | 01 |
| ID | RAILROAD MEDICARE | P00160006 | 01 |
| ID | 806749400 | 05 | |
| ID | BLUE CROSS | DAGV3 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427431808 | Preston Smith | Behavioral Analyst | 14490 E 50th Ave, Denver, CO 80239-6440 | 2015-07-03 |
| 1275821167 | Preston J Smith | Orthopaedic Surgery | 630 N Alvernon Way Ste 351, Tucson, AZ 85711-1838 | 2011-07-13 |
| 1710485008 | Preston Langdon Smith | Optometrist | 1735 S Highway 27, Carrollton, GA 30117-8941 | 2018-02-01 |
| 1538444674 | Preston George Smith | Radiology | 2650 Ridge Ave., Dept. of Radiology, Evanston, IL 60201 | 2011-10-20 |
| Street Address |
215 E HAWAII AVE |
| City | NAMPA |
| State | ID |
| Zip Code | 83686-6011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396740668 | Peter Stevan Jerome | Internal Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2005-06-14 |
| 1174145809 | Carolyn Knackstedt | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
| 1609498336 | Houston Reynolds | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
| 1427670157 | Ali Sup | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
| 1710509443 | Rory Hawker | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-15 |
| 1689295180 | Patricia J Funkhouser | Nurse Practitioner | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-05-06 |
| 1275169252 | Ashley Whitlow | Nurse Practitioner | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-03-21 |
| 1669002721 | Nicole Webb | Physician Assistant | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-01-16 |
| 1548824964 | Catherine Heil | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2019-05-01 |
| 1174187587 | Mark Dahle | Family Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2019-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255960 | Kristine Lynn Fitts-eisenbrandt | Social Worker | 270 W. Gerogia Ave., Nampa, ID 83686 | 2020-01-30 |
| 1669025706 | Vitality Family Chiropractic, Pllc | Chiropractor | 3189 E Greenhurst Rd, Nampa, ID 83686 | 2019-07-18 |
| 1871150185 | King's Peak Investments, Inc. | Substance Abuse Rehabilitation Facility | 8898 Idaho 45, Nampa, ID 83686 | 2019-05-22 |
| 1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
| 1518448703 | Michel Cox | Pharmacy Technician | 2219 12th Ave S, Nampa, ID 83686 | 2018-08-24 |
| 1437504909 | 5 Peppers Inc | Family Medicine | 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 | 2016-05-03 |
| 1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
| 1144699307 | Jamie Green | Social Worker | 112 12th Avenue Rd., Nampa, ID 83686 | 2015-09-17 |
| 1174927933 | Bower Chiropractic Inc | Chiropractor | 304 12th Ave Rd, Nampa, ID 83686 | 2014-10-22 |
| 1285037093 | Rosemary Phelps | Registered Nurse | 353 W. Iowa, Nampa, ID 83686 | 2014-10-07 |
| Find all providers in zip 83686 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174096606 | Derek Scott Ahlstrom | Physician Assistant | 847 Parkcentre Way Ste 7, Nampa, ID 83651-1794 | 2019-01-08 |
| 1083197016 | Jocelyn Ashley Benton | Physician Assistant | 3908 E Flamingo Ave, Nampa, ID 83687-3102 | 2018-09-14 |
| 1376090985 | Stephen Michael Wren | Physician Assistant | 11035 W Karcher Rd, Nampa, ID 83651 | 2016-09-01 |
| 1952799009 | Leslie Arlene Lewis | Physician Assistant | 9850 St Lukes Dr Ste 215, Nampa, ID 83687-7912 | 2014-12-23 |
| 1598192676 | Louie Ward Beech | Physician Assistant | 1510 12th Ave, Ste 200, Nampa, ID 83686 | 2013-10-03 |
| 1629155809 | Kristin Lund Lewis | Physician Assistant | 9850 W St Lukes Dr Ste 129, Nampa, ID 83687-7912 | 2006-11-01 |
| 1043286222 | Mark A Granrud | Physician Assistant | 215 E Hawaii Avenue, Nampa, ID 83686 | 2006-02-27 |
| 1174513188 | Thad W Wilkey | Physician Assistant | 16111 N Brinson St Ste100, Nampa, ID 83687-9203 | 2005-10-21 |
| 1669002721 | Nicole Webb | Physician Assistant | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2020-01-16 |
| 1407493638 | Alison R Dekerchove | Physician Assistant | 1115 12th Ave Rd, Nampa, ID 83686-5738 | 2019-12-06 |
| Find all providers in NAMPA | ||||
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| 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.