Individual provider Active NPI

Victoria Rae Smith, LPN

  • Licensed Practical Nurse
  • Lawrence, KS
National Provider Identifier
1104062017
Registry record updated Dec 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
23-17860-112 Issued in KS
Practice address
2415 Massachusetts St
Lawrence, KS 66046-4827
Phone
(785) 843-3750
Fax
(785) 832-4887
NPI assigned
Dec 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 23-17860-112 KS Primary

Addresses

Primary practice location

2415 Massachusetts St
Lawrence, KS 66046-4827

Mailing address

2415 Massachusetts St
Lawrence, KS 66046-4827
Phone (785) 843-3750

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
23-17860-112KSMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1229990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229990400000",
    "number": "1104062017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 MASSACHUSETTS ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660464827",
            "telephone_number": "785-843-3750",
            "fax_number": "785-832-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MASSACHUSETTS ST",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660464827",
            "telephone_number": "785-843-3750",
            "fax_number": "785-832-4887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "VICTORIA",
        "middle_name": "RAE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-23",
        "last_updated": "2008-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "KS",
            "license": "23-17860-112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2008; 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.