Tennyson Antonio Smith

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

353561 Issued in NY

Practice address

24 Parkview Loop
Staten Island, NY 10314-1661

Phone

(917) 293-0146

Fax

(917) 293-0146

NPI assigned

Apr 25, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1745539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1245028729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PARKVIEW LOOP",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141661",
            "telephone_number": "917-293-0146",
            "fax_number": "917-293-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PARKVIEW LOOP",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141661",
            "telephone_number": "917-293-0146",
            "fax_number": "917-293-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TENNYSON",
        "middle_name": "ANTONIO",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-25",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riki Smith, CASAC-T, FAMILY DEV.
• Shakia Smith
• Shawn Angelique Smith, LMSW
• Stacey Smith
• Tara Nelson Smith, MS, PT
• Tiffany Smith
• Tina Marie Smith, RPH
• Victoria Smith
• Estee Smoler, RD
• Steven Smolin

• Family Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; 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.