Timothy R. Smith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS-005436-L Issued in PA

Practice address

1604 SE 3Rd Ave
Gainesville, FL 32641-7346

Phone

(352) 548-1800

Fax

(352) 548-1850

NPI assigned

Aug 11, 2006

Sex

Male

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1497766752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 SE 3RD AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326417346",
            "telephone_number": "352-548-1800",
            "fax_number": "352-548-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 SE 3RD AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326417346",
            "telephone_number": "352-548-1800",
            "fax_number": "352-548-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIMOTHY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS-005436-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Smith, MOT, OTR/L
• Taylor Thomas Smith, LMT
• Tena Tomeka Smith
• Tierra Nicole Smith, MD
• Tiffany Smith
• Tonya Y Smith
• Wade Eldon Smith, R.N.
• William Brit Smith, MD
• Yamir Smith
• Garreth Elizabeth Smoak

• Clinical Psychologist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.