Shyann Monique Smith, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN225069 Issued in GA

Practice address

300 Chastain Center Blvd NW
Kennesaw, GA 30144-5580

Phone

(770) 218-1997

Fax

(770) 218-1975

NPI assigned

May 22, 2019

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1417514639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 RIDENOUR PKWY NW APT 1324",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524541",
            "telephone_number": "404-725-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CHASTAIN CENTER BLVD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445580",
            "telephone_number": "770-218-1997",
            "fax_number": "770-218-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHYANN",
        "middle_name": "MONIQUE",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN225069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Smith
• Kevin Charles Smith Jr., D.C.
• Kristen Dionne Smith, R.N.
• Samuel Smith II, NCC, LPC
• Sheri Smith, P.T.
• Walter Jason Smith, CRNA
• Maryann F Smolko, LPC
• Karla Thomas Snider, PT
• Moya Elizabeth Sommerville-Kelley, M.D.
• Kristina Ivanna Sorrells

• Family Nurse Practitioner in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.