Melissa Smith, GNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

F340605-1 Issued in NY

Practice address

1 Penn PLZ FL 8
New York, NY 10119-0899

Phone

(201) 780-9907

NPI assigned

May 3, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053533208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PENN PLZ FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101190899",
            "telephone_number": "201-780-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PENN PLZ FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101190899",
            "telephone_number": "201-780-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "GNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F340605-1",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00148300",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR13075600",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "493146-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS GNP LICENSE",
            "identifier": "F340605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Benjamin Smith, M.D.
• Matthew Kirk Smith, MD
• McKenzie Smith
• Megan Smith, LMHC
• Melanie Hennebry Smith, MD, PHD
• Meredith Smith
• Mia A Smith, RN
• Michael Smith
• Michael A Smith, ND,HHA,PCW,PNP
• Michael Louis Smith, MD

• Gerontology Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Gerontology Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.