Healthcare Provider Details

I. General information

NPI: 1982654877
Provider Name (Legal Business Name): ANNETTE M SMICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNETTE M SMICK MD

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6110 S MINNESOTA AVE
SIOUX FALLS SD
57108-2549
US

IV. Provider business mailing address

15954 RIVERS EDGE DR
HAYWARD WI
54843-7800
US

V. Phone/Fax

Practice location:
  • Phone: 605-328-5800
  • Fax: 605-312-9031
Mailing address:
  • Phone: 715-634-2541
  • Fax: 507-453-6263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number32760
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number45963
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number16872
License Number StateSD
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number32760
License Number StateMN
# 5
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number16872
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier31924800
Identifier TypeMEDICAID
Identifier StateWI
Identifier Issuer
# 2
Identifier543063100
Identifier TypeMEDICAID
Identifier StateMN
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: