Nancy Wednesday Smith, STATE PROVIDER

Primary specialty

DriverTaxonomy code 172A00000X

License

050381871 Issued in GA

Practice address

1705 Fellowship Dr
Valdosta, GA 31602-7190

Phone

(229) 305-1496

NPI assigned

Sep 25, 2023

Sex

Female

Sole proprietor

Yes

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": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1497534085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 FELLOWSHIP DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316027190",
            "telephone_number": "229-305-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 FELLOWSHIP DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316027190",
            "telephone_number": "229-305-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NANCY",
        "middle_name": "WEDNESDAY",
        "credential": "STATE PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "GA",
            "license": "050381871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelique Smith
• Courtney Amanda Smith
• Frank Q Smith, MD
• Larry E Smith, M.D.
• Leon F Smith, M.D.
• Randall Lamar Smith, D.D.S
• Sean Smith
• Teresa Smith
• Thomas Briggs Smotherman, D.C
• Bari Snipes, LMFT

• All providers in Valdosta, GA
• Driver in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.