Individual provider Active NPI

Danielle Crumble Smith, R.D.N, L.D.

  • Registered Dietitian
  • Flintstone, GA
National Provider Identifier
1174980502
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
467 Hidden Oaks Dr
Flintstone, GA 30725-2746
Phone
(907) 290-1635
NPI assigned
Jan 15, 2016
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary
Pediatric Nutrition Registered Dietitian 133VN1004X NU
Metabolic Nutrition Registered Dietitian 133VN1006X NU
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X NU
Sports Dietetics Nutrition Registered Dietitian 133VN1501X NU

Addresses

Primary practice location

467 Hidden Oaks Dr
Flintstone, GA 30725-2746

Mailing address

467 Hidden Oaks Dr
Flintstone, GA 30725-2746
Phone (907) 290-1635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2016 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eat Well Live Well Dietitian, Registered CurrentSince Dec 22, 2024 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
Avante Medical Center, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9026/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1174980502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 HIDDEN OAKS DR",
            "city": "FLINTSTONE",
            "state": "GA",
            "postal_code": "307252746",
            "telephone_number": "907-290-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 HIDDEN OAKS DR",
            "city": "FLINTSTONE",
            "state": "GA",
            "postal_code": "307252746",
            "telephone_number": "907-290-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMBLE SMITH",
        "first_name": "DANIELLE",
        "credential": "R.D.N, L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2024-12-17",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flintstone, GA

Sources for this page

Verify at the official NPI Registry.