Andrea Smith, MS, ATC/R

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000008700 Issued in WV

Practice address

2828 1St Ave Ste 400
Huntington, WV 25702-1236

Phone

(304) 525-6905

Fax

(304) 529-6880

NPI assigned

Aug 31, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1144697749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 1ST AVE STE 400",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021236",
            "telephone_number": "304-525-6905",
            "fax_number": "304-529-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 1ST AVE STE 400",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021236",
            "telephone_number": "304-525-6905",
            "fax_number": "304-529-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "MS, ATC/R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WV",
            "license": "2000008700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010681000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352265",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Catherine Smith-Wilson, LGSW
• Caitlyn Nicole Smith-Zimmerman, MSW, LGSW
• Alexandria Nicole Smith
• Amy Leigh Smith, MD
• Andre Smith
• Ashley Smith
• Betty Smith
• Bradley Smith, RBT
• Brooke Smith, PTA
• Chadwick Ray Smith, M.D.

• Athletic Trainer in Huntington, WV
• Providers in Huntington, WV by specialty
• Athletic Trainer in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.