Tyree Darnell Smith, MSN, CRNP, CPNP-AC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP014445 Issued in PA

Practice address

34 Street and Civic Center Blvd
1St Floor Wood Building
Philadelphia, PA 19104

Phone

(215) 590-3440

NPI assigned

Nov 13, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

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.

• Children'S Surgical Associates LTD

  • Pediatric Surgery Physician
  • Philadelphia, PA
  • NPI 1760562581
  NPD (past)

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1184020554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 MERRIBROOK LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191512717",
            "telephone_number": "215-888-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 STREET AND CIVIC CENTER BLVD",
            "address_2": "1ST FLOOR WOOD BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-590-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYREE",
        "middle_name": "DARNELL",
        "credential": "MSN, CRNP, CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-13",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP014445",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP014445",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "PA",
            "license": "SP014445",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terresa Smith
• Theresa Marie Smith, MSN, CRNP-BC
• Timothy Craig Smith, M.D.
• Todd Freeman Smith, O.D.
• Tracy Marie Smith, PA-C
• Valerie Anne Smith, PT
• Victoria Lynn Smith
• Whitney Renee Smith, MD
• William R Smith V, MD, PHD
• Zachary Allen Smith

• Pediatric Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.