Active NPI
D Smith
- Durable Medical Equipment & Medical Supplies
- Dateland, AZ
National Provider Identifier
1174065304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Practice address
- 57899 W Rhodes Ave
Dateland, AZ 85333-5540 - Phone
- (623) 256-3963
- NPI assigned
- Nov 4, 2016
- Last updated
- Feb 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| SMITHDANG411 | AZ | MD | Customized 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.