Ellen M Smith, PH(C), MS, APRN-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

025381-23-05 Issued in NH

Practice address

1 Medical Center Dr
Lebanon, NH 03756-1000

Phone

(603) 650-8626

Fax

(603) 650-7791

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205948833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-8626",
            "fax_number": "603-650-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-8626",
            "fax_number": "603-650-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ELLEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PH(C),  MS, APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NH",
            "license": "025381-23-05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30011307",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0NP0987",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen M Sloop, CRNA
• Vanessa B Smist, PA
• Johnnie L Smith-Shull, LICSW
• Andrew J Smith, PHD
• Christian Taylor Smith, MD
• Jean M Smith, OTR/L
• Karen Griffiths Smith
• Kerrington David Smith, M.D.
• Mark Christopher Smith, M.D.
• Matthew G Smith, APRN

• Adult Health Nurse Practitioner in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Adult Health Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.