Michael J Smith, RPH

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

303094 Issued in MN

Practice address

11400 Julianne Ave N
Stillwater, MN 55082-9436

Phone

(612) 454-2401

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1043436942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 LINWOOD AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053203",
            "telephone_number": "603-387-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 JULIANNE AVE N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550829436",
            "telephone_number": "612-454-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NH",
            "license": "2206",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail L Smith, OTR
• Anna Smith
• Cori L Smith, OTR
• Justin Smith, DC, LAT
• Leah B Smith, PTA
• Stanley Lamar Smith, MD
• Susan Marie Smith, CPNP
• Emma Hembrough Snyder
• Mary Ellen Snyder
• Snyders Drug

• Addiction (Substance Use Disorder) Counselor in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.