Shirley Joan Smart, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

20043442A Issued in IN

Practice address

2325 Intelliplex Dr Ste 207
Shelbyville, IN 46176-8546

Phone

(317) 392-2971

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Shirley Joann Smart Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: commonwealthcounselingassociates.shirleyjoansmart@134000.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1457431264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W RAMPART ST STE 200",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768846",
            "telephone_number": "317-421-2012",
            "fax_number": "317-398-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 INTELLIPLEX DR STE 207",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768546",
            "telephone_number": "317-392-2971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "address_purpose": "LOCATION",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "country_code": "US",
            "telephone_number": "910-450-4136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMART",
        "first_name": "SHIRLEY",
        "middle_name": "JOAN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "AZ",
            "license": "3805",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20043442A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "SMART",
            "middle_name": "JOANN",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Shirrell
• Alison Simo, MSN, RN
• Angela Patrice Sims
• Amber Sitterding
• Denise Lorene Skinner, FNP-BC
• Brookelyn Smith
• Caitlyn Smith, LSW
• Rebecca J Smith
• Victoria Smith
• SNH Indy Tenant LLC (McKay Manor)

• Psychologist in Shelbyville, IN
• Providers in Shelbyville, IN by specialty
• Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.