Active NPI
Aybianeth Carolina Smart
- Clinical Social Worker
- Walker, MI
National Provider Identifier
1104366996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801096255
- Practice address
- 721 N Center Dr NW
Walker, MI 49544-8215 - Phone
- (616) 340-1776
- NPI assigned
- Feb 28, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801096255 | MI | |
| Clinical Social Worker | 1041C0700X | 6801096255 | MI | Primary |
Addresses
Primary practice location
721 N Center Dr NW
Walker, MI 49544-8215
Mailing address
717 N Center Dr NW
Grand Rapids, MI 49544-8215
Phone (989) 400-0394
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801096255 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669593600000",
"number": "1104366996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 N CENTER DR NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495448215",
"telephone_number": "989-400-0394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 N CENTER DR NW",
"city": "WALKER",
"state": "MI",
"postal_code": "495448215",
"telephone_number": "616-340-1776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMART",
"first_name": "AYBIANETH",
"middle_name": "CAROLINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-28",
"last_updated": "2022-11-28",
"certification_date": "2022-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801096255",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801096255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walker, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.