Johnny R Smith, RN

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

R0074090 Issued in OK

Practice address

2301 S Eight Tribes TRL
Miami, OK 74354-1009

Phone

(918) 542-1655

NPI assigned

Jan 11, 2011

Last updated

Jan 11, 2011By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeastern Tribal Health System

  • Clinic/Center
  • Miami, OK
  • NPI 1871522532
  NPD (past)

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1114222809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S EIGHT TRIBES TRL",
            "address_2": "PO BOX 1498",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743541009",
            "telephone_number": "918-542-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S EIGHT TRIBES TRL",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "743541009",
            "telephone_number": "918-542-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHNNY",
        "middle_name": "R",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "OK",
            "license": "R0074090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Alicia Smart, LMSW
• Smiles Family Dental Care, PLC
• Caitlin Sue Smith
• Christian Adaire Smith
• Douglas Smith
• Rachael Cecelia Smith, FNP-C
• William K Smith, MD
• Jequita Dawn Snyder, D.O.
• Edward Lynn Sommerhauser, CRNA
• Tamara Danette Soria, MSW

• Diabetes Educator Registered Nurse in Miami, OK
• Providers in Miami, OK by specialty
• Diabetes Educator Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.