Individual provider Active NPI

Ilia Jamila Smith, APRN, CNM, WHNP-BC

  • Advanced Practice Midwife
  • Dallas, TX
National Provider Identifier
1245567643
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP140725 Issued in TX
Practice address
2922B Martin Luther King Jr Blvd
Dallas, TX 75215-2321
Phone
(214) 426-3645
NPI assigned
Nov 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 871226 TX
Women's Health Nurse Practitioner 363LW0102X 95003008 CA
Women's Health Nurse Practitioner 363LW0102X AP140725 TX
Advanced Practice Midwife 367A00000X 235755 CA
Advanced Practice Midwife 367A00000X 209007796 IL
Advanced Practice Midwife 367A00000X AP140725 TX Primary

Addresses

Primary practice location

2922B Martin Luther King Jr Blvd
Dallas, TX 75215-2321

Mailing address

2922B Martin Luther King Jr Blvd
Dallas, TX 75215-2321
Phone (214) 426-3645

Other names 1

  • Ilia J Smith Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190909001963 TX Practitioner - Nurse Practitioner 6901075431 Reassigns benefits to 3 organizations
I20260409001578 TX Practitioner - Certified Nurse Midwife (CNM) 6901075431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6752 San Roque
Irving, TX 75039-3234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
871226TXMDRegistered Nurse
235755CAMDAdvanced Practice Midwife
209007796ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Orsel S. McGhee III M.D., P.a. CurrentSince Jan 29, 2024 Accepting new patients
Atlas Holistic Health PLLC Current Accepting new patients
The Pursuit of Wellness Current Accepting new patients
Martin Luther King Jr Family Clinic CurrentSince Feb 1, 2023 Accepting new patients
Womens Urgent Care and Wellness Centers Current Accepting new patients
Blue Island HBP Medical Group LLC Past Accepting new patients
Dallas County Mental Health & Mental Retardation Center PastSince Feb 1, 2023 Accepting new patients
MSMC Investors, LLC Advanced Practice Midwife Past Accepting new patients

Locations

2922 Mlk Blvd
#B
Dallas, TX 75215
Phone (214) 425-3645

2922 Martin Luther King Jr Blvd
Dallas, TX 75215
Phone (214) 426-3645

2922 Martin Luther King Jr Blvd
Bldg B
Dallas, TX 75215
Phone (214) 426-3645

1244 William D Tate Ave
Grapevine, TX 76051
Phone (817) 416-9800

617 W Moore Ave
Ste B
Terrell, TX 75160
Phone (972) 563-8100

Interoperability endpoints

  • Direct secure messaging: ilia.smith.1@17390.direct.athenahealth.com
  • Direct secure messaging: ismithrandle113840@direct.phhs.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1245567643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2922B MARTIN LUTHER KING JR BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752152321",
            "telephone_number": "214-426-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2922B MARTIN LUTHER KING JR BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752152321",
            "telephone_number": "214-426-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ILIA",
        "middle_name": "JAMILA",
        "credential": "APRN, CNM, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "871226",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95003008",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "AP140725",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "235755",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209007796",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "AP140725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILIA",
            "last_name": "SMITH",
            "middle_name": "J",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.