Individual provider Active NPI

Cory Smid

  • Genetic Counselor (M.S.)
  • Milwaukee, WI
National Provider Identifier
1235776824
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
Practice address
9000 W Wisconsin Ave # Ms 716
Milwaukee, WI 53226-4874
Phone
(414) 266-4511
NPI assigned
Dec 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave # Ms 716
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave # Ms 716
Milwaukee, WI 53226-4874

Other identifiers 1

IdentifierTypeStateIssuer
18727OtherWIABGC CERTIFICATION NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csmid@mcw.edu

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1235776824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 716",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 716",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMID",
        "first_name": "CORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-03",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABGC CERTIFICATION NUMBER",
            "identifier": "18727",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csmid@mcw.edu",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "9000 W Wisconsin Ave # MS 716",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532264874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.