Amanda M Smith

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R0124662 Issued in OK

Practice address

31652 S Gaylene Dr
Inola, OK 74036-5814

Phone

(918) 864-6822

NPI assigned

Feb 7, 2024

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Amanda M Mitchell Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 8, 2024.

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1497519912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31652 S GAYLENE DR",
            "city": "INOLA",
            "state": "OK",
            "postal_code": "740365814",
            "telephone_number": "918-864-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31652 S GAYLENE DR",
            "city": "INOLA",
            "state": "OK",
            "postal_code": "740365814",
            "telephone_number": "918-864-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMANDA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0124662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MITCHELL",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Inola, OK
• Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.