Individual provider Active NPI

Joann Fly-Smith

  • Case Management Agency
  • Valparaiso, IN
National Provider Identifier
1427896265
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Practice address
2106 Morthland Dr # 1149
Valparaiso, IN 46383-5914
Phone
(469) 667-7972
Fax
(888) 379-3899
NPI assigned
Jul 16, 2024
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

2106 Morthland Dr # 1149
Valparaiso, IN 46383-5914

Mailing address

2106 Morthland Dr # 1149
Valparaiso, IN 46383-5914
Phone (469) 667-7972

Other identifiers 1

IdentifierTypeStateIssuer
300086594MedicaidIN

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": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1427896265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 MORTHLAND DR # 1149",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463835914",
            "telephone_number": "469-667-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 MORTHLAND DR # 1149",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463835914",
            "telephone_number": "469-667-7972",
            "fax_number": "888-379-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLY-SMITH",
        "first_name": "JOANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300086594",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.