Individual provider Active NPI

Smitha Georgy, NP- BC

  • Family Nurse Practitioner
  • Redford, MI
National Provider Identifier
1356811822
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704251884 Issued in MI
Practice address
26129 W 6 Mile Rd
Redford, MI 48240-2218
Phone
(313) 543-3100
NPI assigned
Nov 27, 2018
Last updated
Nov 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704251884 MI Primary
Registered Nurse 163W00000X 4704251884 MI

Addresses

Primary practice location

26129 W 6 Mile Rd
Redford, MI 48240-2218

Mailing address

48615 Red Oak Dr
Shelby Township, MI 48315-4050
Phone (248) 835-7517

Other practice location 1

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-0610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190315001205 MI Practitioner - Nurse Practitioner 0244570943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vitality Visiting Physicians PLLCGroup PAC ID 2961870969, 7 clinicians

Practice addresses (Care Compare)

16250 Northland Dr
Southfield, MI 48075-5228
Phone (248) 862-5311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704251884MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Visiting Physicians, PLLC CurrentSince Oct 9, 2023 Accepting new patients
Wings of Angel Home Health Care, LLC PastSince Apr 1, 2022 Accepting new patients
MVP Diagnostic Laboratory LLC PastSince Sep 1, 2020 Accepting new patients

Locations

16250 Northland Dr
Ste 318
Southfield, MI 48075
Phone (248) 862-5311

4007 Carpenter Rd
Ypsilanti, MI 48197
Phone (586) 419-3007

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1356811822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48615 RED OAK DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154050",
            "telephone_number": "248-835-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26129 W 6 MILE RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482402218",
            "telephone_number": "313-543-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-0610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGY",
        "first_name": "SMITHA",
        "name_prefix": "Mrs.",
        "credential": "NP- BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2022-11-10",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704251884",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704251884",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

Verify at the official NPI Registry.