Individual provider Active NPI

Sierra H Smith, APSW

  • Social Worker
  • Wausau, WI
National Provider Identifier
1043051717
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
134905-121 Issued in WI
Practice address
227400 Rib Mountain Dr Ste D
Wausau, WI 54401-5049
Phone
(715) 302-2805
NPI assigned
Jun 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 134905-121 WI Primary

Addresses

Primary practice location

227400 Rib Mountain Dr Ste D
Wausau, WI 54401-5049

Mailing address

713 S Genesee St
Merrill, WI 54452-3325
Phone (715) 302-2805

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
134905-121WIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1043051717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 S GENESEE ST",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544523325",
            "telephone_number": "715-302-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227400 RIB MOUNTAIN DR STE D",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015049",
            "telephone_number": "715-302-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SIERRA",
        "middle_name": "H",
        "credential": "APSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "134905-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.