Active NPI
Eugenia Smith, NURSE PRACTITIONER
- Nurse Practitioner
- Detroit, MI
National Provider Identifier
1487225520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3704241370
- Practice address
- 400 Mack Ave
Detroit, MI 48201-2136 - Phone
- (877) 929-6342
- NPI assigned
- Jul 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3704241370 | MI | Primary |
Addresses
Primary practice location
400 Mack Ave
Detroit, MI 48201-2136
Mailing address
32556 Firwood Dr
Warren, MI 48088-1544
Phone (248) 497-6507
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3704241370 | Other | MI | APRN LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Waynehealth@med.wayne.edu | Health Information Exchange (HIE) |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3704241370 | MI | MD | Nurse Practitioner |
Interoperability endpoints
- waynehealth@med.wayne.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625788800000",
"number": "1487225520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32556 FIRWOOD DR",
"city": "WARREN",
"state": "MI",
"postal_code": "480881544",
"telephone_number": "248-497-6507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 MACK AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012136",
"telephone_number": "877-929-6342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "EUGENIA",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-09",
"last_updated": "2021-07-09",
"certification_date": "2021-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "3704241370",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APRN LICENSE",
"identifier": "3704241370",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Waynehealth@med.wayne.edu",
"affiliation": "N",
"endpointDescription": "Healthcare Provider",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Communication",
"address_1": "32556 Firwood Dr",
"city": "Warren",
"state": "MI",
"country_code": "US",
"postal_code": "480881544",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.