Individual provider Active NPI

Rhonda Jean Smith, LPN

  • Licensed Practical Nurse
  • Bremen, GA
National Provider Identifier
1134644107
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN09729 Issued in GA
Practice address
1449 Temple Rd
Bremen, GA 30110-2378
Phone
(770) 534-2367
Fax
(770) 537-1203
NPI assigned
Aug 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN09729 GA Primary

Addresses

Primary practice location

1449 Temple Rd
Bremen, GA 30110-2378

Mailing address

1449 Temple Rd
Bremen, GA 30110-2378
Phone (770) 534-2367

Other names 1

  • Rhonda Jean Smith Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN09729GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134644107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 TEMPLE RD",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301102378",
            "telephone_number": "770-534-2367",
            "fax_number": "770-537-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 TEMPLE RD",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301102378",
            "telephone_number": "770-534-2367",
            "fax_number": "770-537-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RHONDA",
        "middle_name": "JEAN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN09729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RHONDA",
            "last_name": "SMITH",
            "middle_name": "JEAN",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bremen, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.