Latisha Smith, ED.S.

Primary specialty

School PsychologistTaxonomy code 103TS0200X

Practice address

600 S. Smiley St.
O'Fallon, IL 62269

Phone

(618) 632-3507

NPI assigned

Nov 30, 2017

Sex

Female

Sole proprietor

No

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

• O'Fallon Township High School Dist 203

  • Local Education Agency (LEA)
  • O Fallon, IL
  • NPI 1184849952
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 30, 2017.

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1134633993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S. SMILEY ST.",
            "city": "O'FALLON",
            "state": "IL",
            "postal_code": "62269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S. SMILEY ST.",
            "city": "O'FALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-632-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LATISHA",
        "credential": "ED.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam'S Club Optical
• Sams West Inc
• Alex Joseph Schillinger, DMD
• Danielle Schoenbacher, MS, ATC, LATC, PES
• Stephanie Lynn Simpson, D.O.
• Southwest Family & Childrens Testing & Therapy Clinic
• Susan Elizabeth Stewart, A.N.P.
• Brenna M Thomas, CRNA
• Bradley J Tissier, MD
• Hina Usman, MD

• All providers in O'Fallon, IL
• School Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.