Tracey Denise Smith

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2019005978 Issued in MO

Practice address

12453 Charlotte St
Kansas City, MO 64146-1310

Phone

(913) 788-0227

NPI assigned

May 8, 2019

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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1417512039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12453 CHARLOTTE ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641461310",
            "telephone_number": "913-788-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12453 CHARLOTTE ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641461310",
            "telephone_number": "913-788-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TRACEY",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019005978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamirria Smith
• Terence Larue Smith, CPS
• Terry R. Smith, CRNA
• Timothy W. Smith, M.D.
• Todd Daniel Smith, RN
• Traci Lynn Smith, LPC
• Tyler Joel Smith, D.C.
• Tyler K Smith, MD, MPH
• Valerie F Smith, PHARMD
• Veronica Danyelle Smith, MD

• Family Nurse Practitioner in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.