Active NPI
Patricia L Smith, CHN 1
- Registered Nurse
- Canton, NY
National Provider Identifier
1376788737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 309376-1
- Practice address
- 80 SH 310
Suite 2
Canton, NY 13617-1476 - Phone
- (315) 386-2325
- Fax
- (315) 386-2744
- NPI assigned
- Dec 12, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | 309376-1 | NY | |
| Registered Nurse | 163W00000X | 309376-1 | NY | Primary |
| Home Health Registered Nurse | 163WH0200X | 309376-1 | NY |
Addresses
Primary practice location
80 SH 310
Suite 2
Canton, NY 13617-1476
Mailing address
80 State Highway 310
Suite 2
Canton, NY 13617-1436
Phone (315) 386-2325
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309376-1 | NY | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429574400000",
"number": "1376788737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 STATE HIGHWAY 310",
"address_2": "SUITE 2",
"city": "CANTON",
"state": "NY",
"postal_code": "136171436",
"telephone_number": "315-386-2325",
"fax_number": "315-386-2744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 SH 310",
"address_2": "SUITE 2",
"city": "CANTON",
"state": "NY",
"postal_code": "136171476",
"telephone_number": "315-386-2325",
"fax_number": "315-386-2744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "PATRICIA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "CHN 1",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-12",
"last_updated": "2015-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "NY",
"license": "309376-1",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "309376-1",
"primary": true
},
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "NY",
"license": "309376-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Canton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.