Tim M Smith

Primary specialty

Clinical Exercise PhysiologistTaxonomy code 224Y00000X

License

CEP.CE0198 Issued in LA

Practice address

3200 Greenwood Rd.
Shreveport, LA 71103

Phone

(318) 212-4450

NPI assigned

Nov 4, 2011

Sex

Male

Sole proprietor

No

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": "1320364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1346527330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 WEAVERS WAY",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112097",
            "telephone_number": "318-617-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 GREENWOOD RD.",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71103",
            "telephone_number": "318-212-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIM",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "LA",
            "license": "CEP.CE0198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Talesha Antoinette Smith
• Tamica Smith
• Tasha Smith, PHARM.D.
• Tasha Smith
• Thomas L. Smith, CRNA
• Tremond Smith
• Trenton Smith
• Trevor Smith
• Twanda Smith
• Vanessa Smith

• Clinical Exercise Physiologist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Clinical Exercise Physiologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.