Deraisha D Smith Harris

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

171M00000X Issued in OK

Practice address

2325 S Harvard Ave
Tulsa, OK 74114-3300

Phone

(918) 712-4301

Fax

(918) 560-1399

NPI assigned

Jan 19, 2022

Sex

Female

Sole proprietor

No

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": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1508518747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143300",
            "telephone_number": "918-712-4301",
            "fax_number": "918-560-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 S HARVARD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741143300",
            "telephone_number": "918-712-4301",
            "fax_number": "918-560-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH HARRIS",
        "first_name": "DERAISHA",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OK",
            "license": "171M00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smile Stop Dental, LLC
• Smiles Family Dental, PLLC
• Jeromy Smiley
• Smith General Dentistry, Inc.
• Laketa Smith Halpine, D.O.
• Amanda Marie Smith-McCready
• Jerrica Delny Smith-McCullough
• Wynter Smith-McElhannon
• Ryan J Smith-Rybacki
• Jennifer Marie Smith-Woosley, APRN-CNP

• Case Manager/Care Coordinator in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.