Lavon Lashanda Smith, BSN, RN

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Practice address

115 S Cedar Ave
Maple Shade, NJ 08052-1711

Phone

(856) 571-3312

NPI assigned

Dec 21, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Lavon Lashanda Walker Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• JLS Diagnostics

  • Clinical Medical Laboratory
  • Maple Shade, NJ
  • NPI 1871244509
  NPD Authorized official

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1508372897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S CEDAR AVE # LEVEL1",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080521711",
            "telephone_number": "856-571-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S CEDAR AVE",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080521711",
            "telephone_number": "856-571-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAVON",
        "middle_name": "LASHANDA",
        "credential": "BSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN681687",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR18139900",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508372897",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lasmith@premiernursestaffing.com",
            "affiliation": "N",
            "address_1": "115 S Cedar Ave",
            "address_2": "Level 1",
            "city": "Maple Shade",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAVON",
            "last_name": "WALKER",
            "middle_name": "LASHANDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric Simpkins
• Jay Singh, MD
• Smith Apothecary Corp
• Smith Apothecary Corp
• Ambrial Smith, MSW, LSW
• Patricia Spuler, DPT
• Star Alliance Support Services
• Stephen E Paul DO PA
• Steven Reiner, DPM
• Wilma Isabel Suero Castro

• Clinical Medical Laboratory in Maple Shade, NJ
• Providers in Maple Shade, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.

Verify at the official NPI Registry.