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

Tanner R Smith, PA

Individual provider Physician Assistant · NPI 1477288801

Tanner R Smith, PA is a Physician Assistant in Goodyear, Arizona. Qualified in 2022, 4 years ago. Practices with Clear Sky Dermatology LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2022
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

2620 N 140th Ave Ste 103
Goodyear, AZ 85395-2437
Phone: (623) 219-4777
Fax: (623) 219-4778
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9328 (AZ)

Record details

NPI number1477288801
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 20, 2022
Last updated in NPPESDecember 14, 2022
Certification dateDecember 14, 2022
Mailing address2620 N 140th Ave Ste 103, Goodyear, AZ 85395-2437

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Clear Sky Dermatology Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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