Organization Active NPI

Alice Carole Smith

  • Durable Medical Equipment & Medical Supplies
  • Kalamazoo, MI
National Provider Identifier
1174706204
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ALICE CAROLE SMITH
Practice address
1406 S Westnedge Ave
Kalamazoo, MI 49008-1371
Phone
(269) 383-2350
NPI assigned
Dec 12, 2007
Last updated
Mar 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Alice Carole Smith, R.N., B.S.
Title
Owner
Phone
(269) 383-2350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1406 S Westnedge Ave
Kalamazoo, MI 49008-1371

Mailing address

1406 S Westnedge Ave
Kalamazoo, MI 49008-1371
Phone (269) 383-2350

Other identifiers 2

IdentifierTypeStateIssuer
OC90305OtherMIBLUE CROSS
1957419MedicaidMI

Other names 1

  • Diabetic Center Former legal business name

National Provider Directory

National Provider Directory

Locations

1406 S Westnedge Ave
Kalamazoo, MI 49008
Phone (269) 383-2350

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1174706204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 S WESTNEDGE AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081371",
            "telephone_number": "269-383-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 S WESTNEDGE AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081371",
            "telephone_number": "269-383-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICE CAROLE SMITH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "CAROLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-383-2350",
        "authorized_official_credential": "R.N., B.S."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "OC90305",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1957419",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetic Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.