Tina I Smith, PSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

3211 Autumn Chase Way NE Apt 104
Salem, OR 97305-1561

Phone

(971) 239-9675

NPI assigned

May 17, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1368748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1053757948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 AUTUMN CHASE WAY NE APT 104",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051561",
            "telephone_number": "971-239-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 AUTUMN CHASE WAY NE APT 104",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051561",
            "telephone_number": "971-239-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TINA",
        "middle_name": "I",
        "name_prefix": "Ms.",
        "credential": "PSS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-17",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "O5329",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shetaye Smith, RN
• Sierra Lynn Smith, THW,PSS,CRM
• Simona Smith, LPC-A
• Stephanie A Smith, RDH
• Teresa Diane Smith, RDH
• Andrew Smittle, CADC-R
• Michael Smolin, M.D.
• Marilyn B Smyres, LCSW
• Kaitlyn Snapp
• Ana Snegireff

• Peer Specialist in Salem, OR
• Providers in Salem, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.