Active NPI
Samantha Marie Smith, RDN
- Registered Dietitian
- Farmingdale, NY
National Provider Identifier
1306722657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 012801-01
- Practice address
- 54 Colonial Dr
Farmingdale, NY 11735-3150 - Phone
- (516) 510-4743
- NPI assigned
- Aug 13, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 012801-01 | NY | Primary |
Addresses
Primary practice location
54 Colonial Dr
Farmingdale, NY 11735-3150
Mailing address
54 Colonial Dr
Farmingdale, NY 11735-3150
Phone (516) 510-4743
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
| License | State | Type | Specialty |
|---|---|---|---|
| 012801-01 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian V. Becker M.a.P.T.PLLC | Past | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| Functional Nutrition Li PLLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Physical Therapist
- Babylon, NY
- NPI 1295824027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755043200000",
"number": "1306722657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 COLONIAL DR",
"city": "FARMINGDALE",
"state": "NY",
"postal_code": "117353150",
"telephone_number": "516-510-4743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 COLONIAL DR",
"city": "FARMINGDALE",
"state": "NY",
"postal_code": "117353150",
"telephone_number": "516-510-4743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "SAMANTHA",
"middle_name": "MARIE",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-13",
"last_updated": "2025-08-13",
"certification_date": "2025-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "012801-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmingdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.