Carla Sue Smith, CNS

Primary specialty

Oncology Clinical Nurse SpecialistTaxonomy code 364SX0200X

License

209.000880 Issued in IL

Practice address

1005 Broadway St
Quincy, IL 62301-2834

Phone

(217) 223-8400

Fax

(217) 214-5675

NPI assigned

Nov 6, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Carla Sue Shaffer Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1124629035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7005",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623057005",
            "telephone_number": "217-223-8400",
            "fax_number": "217-214-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400",
            "fax_number": "217-214-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CARLA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SX0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": "IL",
            "license": "209.000880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "carla.smith@blessinghealth.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1005 Broadway St",
            "city": "Quincy",
            "state": "IL",
            "country_code": "US",
            "postal_code": "623012834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "SHAFFER",
            "middle_name": "SUE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Smart, LCSW
• Abbas Smiley, MD, PHD
• Aaron Smith, DMD
• Alan Smith, PHARMD
• Brendan Scott Smith, DMD
• Destiney Khristine Smith, APRN
• Lakesha Smith, MD
• Laura J Smith, OT
• Miranda Olivia Smith, MD
• Raymond P Smith, MD

• Oncology Clinical Nurse Specialist in Quincy, IL
• Providers in Quincy, IL by specialty
• Oncology Clinical Nurse Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.