Individual provider Active NPI

D Smith

  • Durable Medical Equipment & Medical Supplies
  • Dateland, AZ
National Provider Identifier
1174065304
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Practice address
57899 W Rhodes Ave
Dateland, AZ 85333-5540
Phone
(623) 256-3963
NPI assigned
Nov 4, 2016
Last updated
Feb 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Customized Equipment (DME) 332BC3200X SMITHDANG411 AZ
Contractor 171W00000X NU

Addresses

Primary practice location

57899 W Rhodes Ave
Dateland, AZ 85333-5540

Mailing address

57899 W Rhodes Ave
Dateland, AZ 85333-5540
Phone (623) 256-3963

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
SMITHDANG411AZMDCustomized Equipment (DME)

NPI Registry JSON

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1174065304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57899 W RHODES AVE",
            "city": "DATELAND",
            "state": "AZ",
            "postal_code": "853335540",
            "telephone_number": "623-256-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57899 W RHODES AVE",
            "city": "DATELAND",
            "state": "AZ",
            "postal_code": "853335540",
            "telephone_number": "623-256-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "D",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-04",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "AZ",
            "license": "SMITHDANG411",
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dateland, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.