Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ian Michael Smith

Individual provider Athletic Trainer · NPI 1922630607

Ian Michael Smith is an Athletic Trainer in Lake St Louis, Missouri. Works from 2 locations. Licensed in Missouri.

Licensed in
MO
In the registry since
2020

Practice location Address checks out

2275 Sommers Rd
Lake St Louis, MO 63367-6406
Phone: (636) 561-0075
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6309 Ronald Reagan Dr, Lake St Louis, MO 63367-2681 — (636) 755-4566

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2017022695 (MO)

Record details

NPI number1922630607
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 10, 2020
Last updated in NPPESFebruary 10, 2020
Certification dateFebruary 10, 2020
Mailing address110 Rock Bridge Rd, Villa Ridge, MO 63089-2006