Individual provider Active NPI

Nicholas Desmond Smith

  • Chiropractor
  • Cape Coral, FL
National Provider Identifier
1194881201
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 9320 Issued in FL
Practice address
1526 SE 47TH St
Cape Coral, FL 33904-9613
Phone
(239) 549-3266
NPI assigned
Jan 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 9320 FL Primary

Addresses

Primary practice location

1526 SE 47TH St
Cape Coral, FL 33904-9613

Mailing address

1526 SE 47TH St
Cape Coral, FL 33904-9613
Phone (239) 549-3266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070212000559 FL Practitioner - Chiropractic 2163424698 Practice locations: Cape Coral, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1526 SE 47TH St
Cape Coral, FL 33904-9613
Phone (239) 549-3266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 9320FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas D. Smith Chiropractor CurrentSince Apr 6, 2021 Accepting new patients
Desmond J Smith Chiropractor PastSince Apr 20, 2021 Accepting new patients

Locations

1526 SE 47th St
Cape Coral, FL 33904
Phone (239) 549-0854

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194881201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 SE 47TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339049613",
            "telephone_number": "239-549-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 SE 47TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339049613",
            "telephone_number": "239-549-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLAS",
        "middle_name": "DESMOND",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 9320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.