Oraphanh Vongpheth Smith, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

222678-5 Issued in MN

Practice address

801 Twelve Oaks Center Drive
Suite 822
Wayzata, MN 55391

Phone

(952) 456-6561

Fax

(952) 777-1668

NPI assigned

May 10, 2017

Last updated

May 10, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1205362472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 TWELVE OAKS CENTER DRIVE",
            "address_2": "SUITE 822",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "55391",
            "telephone_number": "952-456-6561",
            "fax_number": "952-777-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 TWELVE OAKS CENTER DRIVE",
            "address_2": "SUITE 822",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "55391",
            "telephone_number": "952-456-6561",
            "fax_number": "952-777-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ORAPHANH",
        "middle_name": "VONGPHETH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-10",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "222678-5",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGIESTER NURSE",
            "identifier": "222678-5",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.

Verify at the official NPI Registry.