Nicholas Kenneth Smythe III, PH.D. IN PROGRESS

Primary specialty

EEG TechnicianTaxonomy code 2472E0500X

Practice address

224 W D.L. Ingram Avenue, BLDG. 1408
Cannon Afb, NM 88103

Phone

(334) 390-1795

NPI assigned

Nov 19, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1043035686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 EAGLE LNDG",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363308659",
            "telephone_number": "334-390-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W D.L. INGRAM AVENUE, BLDG. 1408",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "88103",
            "telephone_number": "334-390-1795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTHE",
        "first_name": "NICHOLAS",
        "middle_name": "KENNETH",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PH.D. IN PROGRESS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2472E0500X",
            "taxonomy_group": "",
            "desc": "Technician, Other, EEG",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ray Leroy Schatz III, IDMT
• Kelly Amanda Schneider, DDS
• Richard James Serkowski, DO, MPH, CPE
• June Ellen Shepherd, PH.D.
• Luke Smith, DMD
• Andrew Springstead
• Justin D Sterett, M.D.
• Adam John Taylor, LCSW
• Andrea Theye, PSY. D.
• Kathleen Thomas, DMD

• Other Technician in Cannon Afb, NM
• Providers in Cannon Afb, NM by specialty
• Other Technician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.