Clarence Russell Smith, MSW

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

1311 N Lottie Ave
Oklahoma City, OK 73117-2051

Phone

(405) 600-3074

Fax

(405) 605-8120

NPI assigned

Jul 21, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Clarence R Smith Professional name

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": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1104434638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 N LOTTIE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731172051",
            "telephone_number": "405-600-3074",
            "fax_number": "405-605-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N LOTTIE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731172051",
            "telephone_number": "405-600-3074",
            "fax_number": "405-605-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CLARENCE",
        "middle_name": "RUSSELL",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARENCE",
            "last_name": "SMITH",
            "middle_name": "R",
            "prefix": "MR.",
            "credential": "MSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Christina Smith
• Christopher Smith, DPM
• Christopher Daniel Smith, MD
• Cindy L Smith, L.O., L.PED
• Claire Elizabeth Kunkel Smith, DO
• Courney Smith, L.D.
• Craig Linn Smith
• Cristie Smith
• Dana Renee Smith, PHARMD
• Danece Smith, BSW

• Peer Specialist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.