Nicole Smith

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

310423-031 Issued in WI

Practice address

2858 Kingston Dr
Madison, WI 53713-2849

Phone

(608) 298-7180

Fax

(608) 241-8414

NPI assigned

Oct 27, 2021

Sex

Female

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": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1336803188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2862 KINGSTON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132849",
            "telephone_number": "608-298-7180",
            "fax_number": "608-241-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2858 KINGSTON DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132849",
            "telephone_number": "608-298-7180",
            "fax_number": "608-241-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "310423-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Smith, MD
• Michael Smith, MSW
• Nate Smith, PHARMD
• Nathan Smith
• Nathanael Smith, PMHNP-BC
• Rachel Marie Smith, MD
• Robert J Smith, MD
• Sarah E. Smith, N.P.
• Sarah M Smith, MPT
• Sawyer Smith

• Licensed Practical Nurse in Madison, WI
• Providers in Madison, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.