Individual provider Active NPI

Carlena Minora Smith, REGISTERED NURSE

  • Registered Nurse
  • White Plains, NY
National Provider Identifier
1255540449
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
431263-1 Issued in NY
Practice address
55 Church St
Suite 201
White Plains, NY 10601-1905
Phone
(914) 682-1440
Fax
(914) 682-1441
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 431263-1 NY Primary

Addresses

Primary practice location

55 Church St
Suite 201
White Plains, NY 10601-1905

Mailing address

111 Bruce Ave
Mount Vernon, NY 10552-3014
Phone (914) 663-1845

Other names 1

  • Miss Carlena Minora Smith Professional name

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

State licenses

LicenseStateTypeSpecialty
431263-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255540449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BRUCE AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105523014",
            "telephone_number": "914-663-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CHURCH ST",
            "address_2": "SUITE 201",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106011905",
            "telephone_number": "914-682-1440",
            "fax_number": "914-682-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CARLENA",
        "middle_name": "MINORA",
        "name_prefix": "Miss",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "431263-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLENA",
            "last_name": "SMITH",
            "middle_name": "MINORA",
            "prefix": "MISS",
            "credential": "REGISTERED NURSE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.