Active NPI
Daniel E Smith, RN/APN
- Family Nurse Practitioner
- Memphis, TN
National Provider Identifier
1124086996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 11926
- Practice address
- 262 Danny Thomas PL
Memphis, TN 38105-3678 - Phone
- (901) 595-3006
- Fax
- (901) 595-3842
- NPI assigned
- May 2, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | R853561 | MS | |
| Family Nurse Practitioner | 363LF0000X | 11926 | TN | Primary |
Addresses
Primary practice location
262 Danny Thomas PL
Memphis, TN 38105-3678
Mailing address
262 Danny Thomas PL
Ms 515
Memphis, TN 38105-3678
Phone (901) 595-3006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5440767 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130806000418 | TN | Order and Referring Only - Nurse Practitioner | 7517902521 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349136000000",
"number": "1124086996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PL",
"address_2": "MS 515",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3006",
"fax_number": "901-595-3842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3006",
"fax_number": "901-595-3842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DANIEL",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "RN/APN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-02",
"last_updated": "2012-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "MS",
"license": "R853561",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "11926",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5440767",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.