Tracey Jane Smith, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD003559 Issued in GA

Practice address

401 Crown Mill Dr
Martinez, GA 30907-9439

Phone

(912) 631-1177

NPI assigned

Jul 5, 2006

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)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: tracey.smith@somatus.gadirect.net

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1366473076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CROWN MILL DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079439",
            "telephone_number": "912-631-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CROWN MILL DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079439",
            "telephone_number": "912-631-1177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22999 US Highway 59 North",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "77339",
            "country_code": "US",
            "telephone_number": "281-348-8953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TRACEY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD003559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Smith, LCSW
• Natalie Brooke Smith, C.C.C.-S.L.P.
• Nicchoe N Smith
• Sydney Smith
• Tara Lyn Smith, RBT
• Harry Addison Snowdy Jr., MD
• Ingrid Cassandra Soleyn, RESPITE PROVIDER
• Southern Breeze PCH
• Southern Eye Consultants, LLC
• Southerncare, Inc.

• Registered Dietitian in Martinez, GA
• Providers in Martinez, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.