Individual provider Active NPI

Beth Adelle Smith, AUD

  • Audiologist-Hearing Aid Fitter
  • Goodlettsville, TN
National Provider Identifier
1407964760
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
A0000001365 Issued in TN
Practice address
110 Glancy St
Suite 214
Goodlettsville, TN 37072-2326
Phone
(615) 868-1904
Fax
(615) 868-0336
NPI assigned
Aug 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X A0000001365 TN Primary

Addresses

Primary practice location

110 Glancy St
Suite 214
Goodlettsville, TN 37072-2326

Mailing address

110 Glancy St
Suite 214
Goodlettsville, TN 37072
Phone (615) 868-1904

Other identifiers 1

IdentifierTypeStateIssuer
4078916MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040310001526 TN Practitioner - Qualified Audiologist 8820987761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Florida College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 Glancy St
Suite 214
Goodlettsville, TN 37072-2313
Phone (615) 868-0335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1365TNMDEndodontist
A0000001365TNMDAudiologist-Hearing Aid Fitter

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407964760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 GLANCY ST",
            "address_2": "SUITE 214",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "37072",
            "telephone_number": "615-868-1904",
            "fax_number": "615-868-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 GLANCY ST",
            "address_2": "SUITE 214",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370722326",
            "telephone_number": "615-868-1904",
            "fax_number": "615-868-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BETH",
        "middle_name": "ADELLE",
        "name_prefix": "Mrs.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TN",
            "license": "A0000001365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4078916",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodlettsville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.