Shelly Smith

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703111792 Issued in MI

Practice address

912 Petoskey St
Petoskey, MI 49770-2937

Phone

(231) 881-0266

NPI assigned

Apr 28, 2016

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1437504222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 PETOSKEY ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702937",
            "telephone_number": "231-881-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 PETOSKEY ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702937",
            "telephone_number": "231-881-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703111792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles E Smith, PT
• Heather Jean Smith, CRNA
• Jeffrey D Smith, MD
• Jeffrey M Smith, PT
• Mackenzie Mae Smith
• Stanley R Smith, MD
• Samantha Snyder
• James Lee Sobczak, O.D.
• Theresia Louise Sobczak, O.D.
• Solis Psychotherapy LLC

• Licensed Practical Nurse in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.