Individual provider Active NPI

Yatemiese Smart

  • Licensed Practical Nurse
  • Athens, GA
National Provider Identifier
1134869423
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2995633 Issued in GA
Practice address
250 Bray St
Athens, GA 30601-2203
Phone
(706) 389-6789
NPI assigned
Apr 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 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 2995633 GA Primary

Addresses

Primary practice location

250 Bray St
Athens, GA 30601-2203

Mailing address

295 Highland Park Dr
Athens, GA 30605-3579
Phone (706) 202-1740

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
2995633GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Behavioral Health Systems CurrentSince Apr 17, 2022 Accepting new patients

Locations

250 Bray St
Athens, GA 30601
Phone (706) 542-9746

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1134869423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 HIGHLAND PARK DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053579",
            "telephone_number": "706-202-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BRAY ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306012203",
            "telephone_number": "706-389-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMART",
        "first_name": "YATEMIESE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "2995633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.