Individual provider Active NPI

Holly Sue Smits, LPN

  • Licensed Practical Nurse
  • Grand Rapids, MI
National Provider Identifier
1003232562
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703111783 Issued in MI
Practice address
72 Sheldon Blvd SE
2ND Floor
Grand Rapids, MI 49503-4234
Phone
(616) 742-3051
Fax
(616) 742-3070
NPI assigned
Mar 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703111783 MI Primary

Addresses

Primary practice location

72 Sheldon Blvd SE
2ND Floor
Grand Rapids, MI 49503-4234

Mailing address

1559 Mullins Ave NW
Grand Rapids, MI 49534-2432
Phone (616) 742-0531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4703111783MIMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1003232562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1559 MULLINS AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495342432",
            "telephone_number": "616-742-0531",
            "fax_number": "616-742-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 SHELDON BLVD SE",
            "address_2": "2ND FLOOR",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034234",
            "telephone_number": "616-742-3051",
            "fax_number": "616-742-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITS",
        "first_name": "HOLLY",
        "middle_name": "SUE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703111783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.