Organization Active NPI

Smith Family Medical Healthcare PLLC

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1306103247
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SMITH FAMILY MEDICAL HEALTHCARE PLLC
Practice address
332 W Broadway Ste 216
Louisville, KY 40202-2131
Phone
(502) 963-5959
Fax
(844) 269-9707
NPI assigned
Apr 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Authorized official

Name
Ms. Deborah Smith, APRN
Title
Owner
Phone
(502) 296-5440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

332 W Broadway Ste 216
Louisville, KY 40202-2131

Mailing address

332 W Broadway Ste 216
Louisville, KY 40202-2131
Phone (502) 963-5959

Other identifiers 1

IdentifierTypeStateIssuer
7100203630MedicaidKY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1306103247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 W BROADWAY STE 216",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022131",
            "telephone_number": "502-963-5959",
            "fax_number": "844-269-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 W BROADWAY STE 216",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022131",
            "telephone_number": "502-963-5959",
            "fax_number": "844-269-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH FAMILY MEDICAL HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-17",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-296-5440",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100203630",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.