Individual provider Active NPI

Danyelle M Smith, FNP

  • Family Nurse Practitioner
  • Conyers, GA
National Provider Identifier
1528611522
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN194165 Issued in GA
Practice address
1755 Parker Rd SE Ste A120
Conyers, GA 30094-6665
Phone
(770) 922-5696
Fax
(770) 922-3842
NPI assigned
Jul 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN194165 GA Primary

Addresses

Primary practice location

1755 Parker Rd SE Ste A120
Conyers, GA 30094-6665

Mailing address

565 Old Norcross Rd
Lawrenceville, GA 30046-4308
Phone (770) 995-5131

Other practice location 1

565 Old Norcross Rd
Lawrenceville, GA 30046-4308
Phone (770) 995-5131

Other practice location 2

2987 Clairmont Rd NE Ste 130
Brookhaven, GA 30329-1687
Phone (404) 417-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191216000999 GA Practitioner - Nurse Practitioner 3870927361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Allergy and Asthma Center, LLCGroup PAC ID 9133113111, 5 clinicians

Practice addresses (Care Compare)

1755 Parker Serd
A120
Conyers, GA 30094-6665
Phone (770) 922-5696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Allergy & Asthma Center, LLC CurrentSince Oct 7, 2019 Accepting new patients

Locations

2987 Clairmont Rd NE
Ste 130
Brookhaven, GA 30329
Phone (404) 417-9333

1755 Parker Rd SE
Conyers, GA 30094

1755 Parker Rd SE
Ste A120
Conyers, GA 30094
Phone (770) 922-5696

2390 Wall St SE
Conyers, GA 30013
Phone (770) 922-5696

565 Old Norcross Rd
Ste 101
Lawrenceville, GA 30046
Phone (770) 995-5131

565 Old Norcross Rd
Lawrenceville, GA 30046
Phone (770) 962-5040

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1528611522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464308",
            "telephone_number": "770-995-5131",
            "fax_number": "770-995-3482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 PARKER RD SE STE A120",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946665",
            "telephone_number": "770-922-5696",
            "fax_number": "770-922-3842"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "565 Old Norcross Rd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300464308",
            "country_code": "US",
            "telephone_number": "770-995-5131",
            "fax_number": "770-995-3482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2987 Clairmont Rd NE Ste 130",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "303291687",
            "country_code": "US",
            "telephone_number": "404-417-9333",
            "fax_number": "404-417-9788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANYELLE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN194165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.