MEDICARE: MR. MARK GREGORY SMITH RRT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	227900000X	Registered Respiratory Therapist	RC250	DC
2	227900000X	Registered Respiratory Therapist	YM006446L	PA

General Provider Information

NPI Number	:	1629280599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK GREGORY SMITH RRT

Provider Business Mailing Address
First Line	:	4549 CANDLEWOOD PL
Second Line	:	APT. 305
City	:	RAPID CITY
State	:	SD
Zip	:	57702-1605
Country	:	US
Telephone Number	:	240-422-1979
Fax Number	:

Provider Business Practice Location Address
First Line	:	4549 CANDLEWOOD PL
Second Line	:	APT. 305
City	:	RAPID CITY
State	:	SD
Zip	:	57702-1605
Country	:	US
Telephone Number	:	240-422-1979
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	09/11/2025

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