Individual provider Active NPI

Doria S Smith, LPN

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1396900643
Registry record updated Apr 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
273544 Issued in NY
Practice address
199 Leighton Ave
Rochester, NY 14609-7329
Phone
(585) 351-7870
NPI assigned
Jul 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 273544 NY Primary

Addresses

Primary practice location

199 Leighton Ave
Rochester, NY 14609-7329

Mailing address

PO Box 90654
Rochester, NY 14609-0654
Phone (585) 351-7870

Other identifiers 1

IdentifierTypeStateIssuer
02501499MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1217030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272326400000",
    "number": "1396900643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90654",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146090654",
            "telephone_number": "585-351-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 LEIGHTON AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146097329",
            "telephone_number": "585-351-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DORIA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-26",
        "last_updated": "2010-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "273544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02501499",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; 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.