Active NPI
Cory Addison Smith
- Marriage & Family Therapist
- Rancho Cordova, CA
National Provider Identifier
1497467369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- AMFT134784
- Practice address
- 5201 Dusty Rose Way
Rancho Cordova, CA 95742-8148 - Phone
- (916) 541-0551
- NPI assigned
- Dec 21, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | AMFT134784 | CA | Primary |
Addresses
Primary practice location
5201 Dusty Rose Way
Rancho Cordova, CA 95742-8148
Mailing address
5201 Dusty Rose Way
Rancho Cordova, CA 95742-8148
Phone (916) 541-0551
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5431234 | Other | CA | MEDICAL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMFT134784 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1497467369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5201 DUSTY ROSE WAY",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "957428148",
"telephone_number": "916-541-0551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5201 DUSTY ROSE WAY",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "957428148",
"telephone_number": "916-541-0551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "CORY",
"middle_name": "ADDISON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-12-21",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "AMFT134784",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "5431234",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cordova, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.