Individual provider Active NPI

Daryl Smith, CNA, CBRF CERTIFIED

  • In Home Supportive Care Agency
  • Milwaukee, WI
National Provider Identifier
1144630237
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
NA303604 Issued in WI
Practice address
7050 N Presidio Dr Apt G
Milwaukee, WI 53223-6320
Phone
(414) 430-2938
NPI assigned
Apr 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NA303604 WI Primary

Addresses

Primary practice location

7050 N Presidio Dr Apt G
Milwaukee, WI 53223-6320

Mailing address

7050 N Presidio Dr Apt G
Milwaukee, WI 53223-6320
Phone (414) 430-2938

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
NA303604WIMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1144630237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 N PRESIDIO DR APT G",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532236320",
            "telephone_number": "414-430-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 N PRESIDIO DR APT G",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532236320",
            "telephone_number": "414-430-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DARYL",
        "credential": "CNA, CBRF CERTIFIED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WI",
            "license": "NA303604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.