Shannon K Smith, LMT

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

012899 Issued in NY

Practice address

12 1St St
Riverhead, NY 11901-4602

Phone

(631) 769-4969

NPI assigned

Sep 7, 2024

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

State licenses

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.

• Jjgnp in Adult Health, P.C.

  • Adult Health Nurse Practitioner
  • Mount Sinai, NY
  • NPI 1487133294

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1725667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725667200000",
    "number": "1376378356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 1ST ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119014602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 1ST ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119014602",
            "telephone_number": "631-769-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANNON",
        "middle_name": "K",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-07",
        "last_updated": "2024-09-07",
        "certification_date": "2024-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mechanotherapist",
            "state": "NY",
            "license": "012899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Paige Smith, LMSW
• Gail Smith, LCSW
• Gregory Thomas Smith, DO
• Kasidy Smith, PA-C
• Peter Smith, NP
• Jane So, M.D.
• Kristen Sochol, M.D.
• Dorothy Soljan, P.A.
• William Sommo, M.D.
• Kelli Soranno, LCAT

• Mechanotherapist in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Mechanotherapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2024; 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.