Individual provider Active NPI

Ramel Lamont Smith, PHD

  • Psychologist
  • Milwaukee, WI
National Provider Identifier
1386834687
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2629 057 Issued in WI
Practice address
1020 N 12TH St
Milwaukee, WI 53233-1308
Phone
(414) 277-8980
Fax
(414) 277-8969
NPI assigned
Aug 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2629 057 WI Primary

Addresses

Primary practice location

1020 N 12TH St
Milwaukee, WI 53233-1308

Mailing address

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 277-8980

Other identifiers 1

IdentifierTypeStateIssuer
39155200MedicaidWI

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2629 057WIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1386834687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331308",
            "telephone_number": "414-277-8980",
            "fax_number": "414-277-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331308",
            "telephone_number": "414-277-8980",
            "fax_number": "414-277-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RAMEL",
        "middle_name": "LAMONT",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2629 057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39155200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; 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.