Melissa Anne Smith

Primary specialty

NutritionistTaxonomy code 133N00000X

License

164004906 Issued in IL

Practice address

2501 Fields South Dr
Champaign, IL 61822-3733

Phone

(217) 239-2713

Fax

(217) 356-7964

NPI assigned

Sep 23, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• RMF Nutrition and Wellness

  • Registered Dietitian
  • Savoy, IL
  • NPI 1629794961
  NPD Authorized official
• Champaign County YMCA

  • Occupational Therapist
  • Champaign, IL
  • NPI 1659715498
  NPD (past)

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1164073979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 FIELDS SOUTH DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618223733",
            "telephone_number": "217-239-2713",
            "fax_number": "217-356-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 FIELDS SOUTH DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618223733",
            "telephone_number": "217-239-2713",
            "fax_number": "217-356-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164004906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Ralph Smith, PH.D.
• Jeremy A Smith, LSW
• Keyera J Smith
• Leeanne Smith
• Linda Kay Smith, LCSW
• Michael A. Smith, M.D.
• Nicole Smith, M.S., CCC-SLP
• Sherry Smith, APRN
• Siedah Nicole Smith
• Tiara Lanea Smith, BS

• Nutritionist in Champaign, IL
• Providers in Champaign, IL by specialty
• Nutritionist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.