Active NPI
Angela M Smith, RD, LD, CDM
- Registered Dietitian
- Lebanon, OR
National Provider Identifier
1215085972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 743
- Practice address
- 525 N Santiam Hwy
Lebanon, OR 97355-4363 - Phone
- (541) 258-2101
- Fax
- (541) 451-7862
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 743 | OR | Primary |
Addresses
Primary practice location
525 N Santiam Hwy
Lebanon, OR 97355-4363
Mailing address
600 N 8TH St
Aumsville, OR 97325-8959
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 743 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327622400000",
"number": "1215085972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N 8TH ST",
"city": "AUMSVILLE",
"state": "OR",
"postal_code": "973258959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 N SANTIAM HWY",
"city": "LEBANON",
"state": "OR",
"postal_code": "973554363",
"telephone_number": "541-258-2101",
"fax_number": "541-451-7862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ANGELA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "RD, LD, CDM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2012-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": "743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.