DR. LARRY D SMITH (NPI# 1639131386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639131386 |
| Entity Type | Individual |
| Full Name | DR. LARRY D SMITH |
| Credential | D.O. |
| Practice Address |
19 Lakes Street Nespelem WA 99155 |
| Mailing Address |
Po Box 71 Nespelem WA 99155-0071 |
| Practice Telephone | 5094222900 |
| Practice Fax Number | 5094222946 |
| Mailing Telephone | 5096342900 |
| Mailing Fax Number | 5096342946 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2020-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | OP00001346 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1078310 | 05 | |
| L&I | 0264988 | 01 | |
| WA | MEDICARE PTAN | G8886888 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689159196 | Larry Dale Smith | Counselor | 205 Lelia Ln, Dobson, NC 27017-8767 | 2018-10-01 |
| 1568946994 | Larry Smith | Case Manager/Care Coordinator | 233 E 83, Merrillville, IN 46410 | 2018-09-21 |
| 1033572946 | Larry Smith | Specialist | 5234 Jarman St, Abilene, TX 79601-7002 | 2016-03-30 |
| 1841655909 | Larry Leroy Smith | Counselor | 490 N 500 E, American Fork, UT 84003-1872 | 2015-12-16 |
| 1174995138 | Larry Smith Jr. | Counselor | 6015 Hearne Avenue, Shreveport, LA 71108 | 2015-10-29 |
| 1275905051 | Larry Joseph Smith Jr. | Counselor | 827 Old Spanish Trl, Bay St Louis, MS 39520-2204 | 2015-10-20 |
| 1952690232 | Larry J Smith | Counselor | 114 N Saint Clair Abrams Ave, Tavares, FL 32778-3258 | 2011-04-07 |
| 1215171475 | Larry Eugene Smith Jr. | Physical Therapy Assistant | 1612 Oak St, Kenova, WV 25530-1118 | 2009-04-30 |
| 1104078708 | Larry Darnell Smith | Physical Therapist | 914 Tamarack Ave, Tallahassee, FL 32303-4649 | 2008-10-15 |
| 1700034345 | Larry Nelson Smith | Otolaryngology | 10925 Sw 27th Ave, Gainesville, FL 32608-8937 | 2008-09-08 |
| Street Address |
19 LAKES STREET |
| City | NESPELEM |
| State | WA |
| Zip Code | 99155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730712167 | Katrina Duncan | Technician | 19 Lakes Street, Nespelem, WA 99155 | 2020-02-13 |
| 1326670233 | Sabrina Lynn Brewer | Registered Nurse | 19 Lakes Street, Nespelem, WA 99155 | 2020-02-08 |
| 1154984342 | Wendy Bordelon Hebert | Registered Nurse | 19 Lakes Street, Nespelem, WA 99155 | 2019-04-15 |
| 1346723533 | Jessica R Dennison | Registered Nurse | 19 Lakes Street, Nespelem, WA 99155 | 2018-09-13 |
| 1790293447 | Mary Lou Mccormack | Registered Nurse | 19 Lakes Street, Nespelem, WA 99155 | 2018-01-16 |
| 1154838571 | Rinku Shewa | Registered Nurse | 19 Lakes Street, Nespelem, WA 99155 | 2018-01-08 |
| 1609389808 | Kelli Goslin | Registered Nurse | 19 Lakes Street, Nespelem, WA 99155 | 2017-11-09 |
| 1568810885 | Colville Indian Health Service | Clinic/Center | 19 Lakes Street, Nespelem, WA 99155 | 2016-05-26 |
| 1164864856 | Jerrod R Peterson | Registered Nurse | 19 Lakes Street, Nespelem, WA 99155-0071 | 2013-07-23 |
| 1689948689 | Camille Fiona Alicia Aiken | Dental Hygienist | 19 Lakes Street, Nespelem, WA 99155 | 2012-03-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841655727 | Brittany Carden | Counselor | 21 Colville St, Nespelem, WA 99155 | 2015-12-21 |
| 1265855704 | Linda Charlene Bart | Counselor | 19 Sanpoil St, Nespelem, WA 99155 | 2014-02-03 |
| 1811104334 | Lee Vernon Elton | Emergency Medical Technician, Intermediate | 1 Colville Streets, Nespelem, WA 99155 | 2007-05-16 |
| 1063542645 | Colville Indian Health Center Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Agency Campus Hwy 155, Nespelem, WA 99155 | 2007-03-06 |
| 1306993662 | Gloria H Angelo | Pharmacist | 29 Nespelem-sanpoil, Agency Campus, Nespelem, WA 99155 | 2007-01-05 |
| 1174607931 | Sandra Lee Nomee | Spec/Tech, Pathology | 29 9th Sanpoil Street, Colville Confederated Tribes Indian Health Services, Nespelem, WA 99155 | 2006-10-25 |
| 1265529598 | Confederated Tribes of The Colville Reservation | Ambulance | 405 10th St, Nespelem, WA 99155 | 2006-10-06 |
| 1316954118 | Jose Javier Gomez | Psychologist | 1 Colville St, Nespelem, WA 99155 | 2006-08-02 |
| 1922038884 | Donald L Sanford | Optometrist | 29 Nespelem/san Poil St, Nespelem, WA 99155 | 2006-07-04 |
| 1467052118 | Gloria Means | Registered Nurse | 19 Lakes St, Nespelem, WA 99155 | 2020-10-30 |
| Find all providers in zip 99155 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659985554 | Trans-west Ambulance Service LLC | Emergency Medicine | 526 N West Ave # Pmb112, Arlington, WA 98223-1251 | 2020-09-08 |
| 1629602016 | Franciscan Medical Group | Emergency Medicine | 3556 Market Pl W Ste 109, University Place, WA 98466-4339 | 2020-02-25 |
| 1477010676 | Hcmd LLC | Emergency Medicine | 11477 Nw Admiral Pl, Silverdale, WA 98383-4503 | 2019-02-23 |
| 1801352505 | Western Washington Emergency Physicians Pllc | Emergency Medicine | 14815 Pacific Ave S, Parkland, WA 98444-4654 | 2019-02-18 |
| 1013490507 | Dispatchhealth Washington PC | Emergency Medicine | 6912 220th St Sw Ste 113, Mountlake Terrace, WA 98043-2174 | 2018-09-11 |
| 1659802320 | Anders Conway | Emergency Medicine | 413 Lilly Rd Ne Dept Of, Olympia, WA 98506-5133 | 2017-03-24 |
| 1457705147 | Daniel Hinds | Emergency Medicine | 10019 N Austin Ln, Spokane, WA 99208-6072 | 2016-04-19 |
| 1497140206 | Angus Agnew | Emergency Medicine | 315 M.l.k. Jr. Way, Tacoma, WA 98405 | 2015-03-30 |
| 1518376151 | Karthikeyan Muthuswamy | Emergency Medicine | St Clare Hospital Emergency Department, 11315 Bridgeport Way Sw, Lakewood, WA 98499 | 2014-08-07 |
| 1285041137 | Anthony Guynes | Emergency Medicine | Swedish Phys. Redmond, 18100 Ne Union Hill Rd. Ste 200, Redmond, WA 98052-3330 | 2014-07-11 |
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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.