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

Mr. Cody Charles Smith, PA

Individual provider Physician Assistant · NPI 1548892110

Mr. Cody Charles Smith, PA is a Physician Assistant in Meridian, Idaho. Graduated from Rush Medical College of Rush University in 2019, 7 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California and Idaho.

Years since qualifying
7
Trained at
Rush Medical College of Rush University
Licensed in
CA, ID
In the registry since
2020
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3277 E Louise Dr Fl 2
Meridian, ID 83642-9359
Phone: (208) 381-7335
Fax: (208) 381-7227
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 11795 Education St Ste 220, Auburn, CA 95602-2469 — (530) 886-6850
  • 816 W Cannon St, Fort Worth, TX 76104-3146 — (817) 321-0404

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2484 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA57810 (CA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA57810 (CA)

Record details

NPI number1548892110
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 11, 2020
Last updated in NPPESAugust 8, 2024
Certification dateAugust 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolRUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduated 2019 (7 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

Other providers in Meridian