Bryan Doreko Paul Smith, QP, ITFS, MHFA

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1100 Logger CT Ste E102
Raleigh, NC 27609-8510

Phone

(919) 900-7200

Fax

(919) 900-7201

NPI assigned

Oct 31, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Management Consultants Pro LLC

  • In Home Supportive Care Agency
  • Raleigh, NC
  • NPI 1487225397
  NPD Authorized official
• Management Consultants Pro. LLC

  • In Home Supportive Care Agency
  • Raleigh, NC
  • NPI 1700458478
  NPD Authorized official

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1366159451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 TRASSACKS DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276105497",
            "telephone_number": "919-900-7200",
            "fax_number": "919-900-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LOGGER CT STE E102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276098510",
            "telephone_number": "919-900-7200",
            "fax_number": "919-900-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRYAN",
        "middle_name": "DOREKO PAUL",
        "credential": "QP, ITFS, MHFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-31",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225CA2400X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Assistive Technology Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgtconpro@outlook.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2924 Trassacks Dr",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276105497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blair Smith
• Brandon Lee Smith, RN
• Brian Richard Smith, PT
• Brittani Smith, LCSWA
• Brittany Crystal Smith
• Cameron Elizabeth Smith
• Candice Rachel Smith, LPCA
• Carl Lynwood Smith, M.D.
• Cassandra M Smith, LPCA
• Cayce Watts Smith, PA-C

• Behavior Technician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Behavior Technician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.