Carol Jean Smith

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

205555 Issued in NY

Practice address

80 St Hwy 310 Ste 1
Canton, NY 13617-1493

Phone

(315) 386-2189

Fax

(315) 386-2435

NPI assigned

Oct 20, 2023

Last updated

Oct 20, 2023By the provider in NPPES

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

Practice roles

Locations

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.

• St Lawrence County

  • Community/Behavioral Health Agency
  • Canton, NY
  • NPI 1699898635
  NPD

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1376325662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ST HWY 310 STE 1",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171493",
            "telephone_number": "315-386-2189",
            "fax_number": "315-386-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ST HWY 310 STE 1",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171493",
            "telephone_number": "315-386-2189",
            "fax_number": "315-386-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "205555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeselyn Simpson, RN
• Karen A Simpson, OTR/L
• Kayla Smalling, FNP-C
• Frances Smith Monroe
• Bernard A Smith, LCSW
• Emily E Smith, M.D.
• Patricia L Smith, CHN 1
• Sheena Teresa Smith, CASAC, CTRS
• Christina M Snell, LMHC NCC
• Patricia A Snider, RPA C

• Addiction (Substance Use Disorder) Registered Nurse in Canton, NY
• Providers in Canton, NY by specialty
• Addiction (Substance Use Disorder) Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.