Individual provider Active NPI

Sharonda Renea Smith

  • Driver
  • Atlanta, TX
National Provider Identifier
1053292177
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
15161927 Issued in TX
Practice address
104 N Howe St
Atlanta, TX 75551-2512
Phone
(430) 205-9659
NPI assigned
Sep 8, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DriverGroup: 193400000X SINGLE SPECIALTY GROUP 172A00000X 15161927 TX Primary

Addresses

Primary practice location

104 N Howe St
Atlanta, TX 75551-2512

Mailing address

104 N Howe St
Atlanta, TX 75551-2512
Phone (903) 650-0676

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
15161927TXMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1053292177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N HOWE ST",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "755512512",
            "telephone_number": "903-650-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N HOWE ST",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "755512512",
            "telephone_number": "430-205-9659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHARONDA",
        "middle_name": "RENEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": "TX",
            "license": "15161927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.